Colonoscopy as a screening modality starting at age 50 has recently undergone scrutiny due to concerns over the risks and benefits. We sought to identify factors affecting colonoscopy results amongst ESRD patients undergoing kidney transplant evaluation.

METHOD: We retrospectively studied 900 patients undergoing kidney transplant evaluation from 2009-2012. Patients age ≤ 48, previously diagnosed with colorectal cancer, and those without colonoscopies or pathology reports on record were excluded. Colonoscopy reports were categorized normal (no finding or hyperplastic polyp) or abnormal (adenomatous polyp or carcinoma).

RESULTS: 303 (64.6%) patients had normal colonoscopies and 166 (35.39%) had abnormal colonoscopies, with median age of 59 (48-76) and 61 (49-82) respectively. Chi-square analysis returned multiple variables with p≤0.20 that were then used for logistic regression analysis (figure 1). Regression showed males and increasing age were more likely to have abnormal findings (OR =1.97, [1.27-3.04], p=0.002) and (OR=1.05, [1.01-1.08], p=0.009) respectively. Similar results occurred for patients with dialysis vintage up to 3 years (OR=1.67, [1.10-2.54], p=0.016) or had hypertension as primary cause for renal failure (OR=2.15, [1.34-3.47], 0.002). Dialysis vintage > 3 years was not significantly different (OR=0.713 [0.40-1.29], 0.258), although sample size was small for this group (n= 61).

CONCLUSION: For patients undergoing kidney transplant evaluation, hypertensive renal failure and dialysis vintage up to 3 years may be risk factors for adenomatous findings on colonoscopies. Paradoxically, dialysis vintage of >3 years poses no significant risk for abnormal findings. As adenomatous polyp rates are high for patients undergoing kidney transplant evaluation, screening colonoscopies should be continued.

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