Background: Brazil is the second in total number of kidney transplant (KTx) in the world, and it also the world biggest universal public health system. The identification of risk factors to NA is the first step to prevention of its consequences in KTx. We aimed to access prevalence and factors associated with NA post KTx.

Methods: A cross-sectional study of 100 KTx patients was performed using the triangulation of three diagnostic methods, to classify patients as adherent or non-adherent: The Basel Adherence Scale for Assessment of Immunossupressives – BAASIS, the collateral report and immunossupressives blood levels. Data comprising the five WHO risk factors dimensions to NA (socio-economic, therapy-, patient-, condition- and healthcare team-related) were compared between groups in uni and multivariate analysis.

Results: Sixty-five percent of patients were male, 72% Caucasian, mean age 45.0 ± 13.5 years. 89% received the graft from a living donor and the time after transplantation was 72.3 ± 44.4 months. 51% of patients were classified as non-adherent. Living more than 100km of the transplant center (54.9 vs. 38.8%, p=0.07), family income higher than five reference wages (21.6 vs. 4%, p=0.009), and having access to private health insurance (35.3% vs. 18.4%, p=0.01) were found to be risk factors. In the logistic regression model only family income higher than five reference wages was associated to NA (OR 5.0; IC:1.01-25.1).

Conclusions: In this sample of a immunussupresive medication full access program, the variables associated with NA were related to socio-economic and to the health system. This is the first Brazilian study with appropriate methodology on risk factors and frequency of NA post TXR. These findings support strategies directed to a better social support and identifying other factors, like behavior or individual ones as the reason to NA.

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