Background: The selection of candidates for kidney transplantation remains a challenge due to complex medical and social situations. There is a progressive increase in the numbers of patients with request for replacement of the renal function and indication of evaluation for kidney transplantation, which is not consonant with the increase in the amount of registered on the waiting list for transplantation, without the information of the causes that generated this difference. Methods: To determine the effectiveness of the renal transplant recipient evaluation (registration on the waiting list) and the causes of exclusion for access to waiting list we retrospectively reviewed patients with indication of evaluation for renal transplantation in the period June/2011 to November 2012. The study group included adult patients with indication of renal transplant evaluation by the referent nephrologists prior to January 2012 and who had not completed the evaluation during the period of study (n= 790). Results: The study included patients in the following categories: no prereferral information (n= 79) 10 %; changing of implant center (n= 17) 2 %; refusal to kidney transplant (n= 16) 2 %; in assessment (n= 144) 18 %; definitely exclusion (n= 68) 9 %; transitory exclusion (n= 354) 45 %; suitable for registration (n= 111) 15 %, of which 100 (12 %) completed the registration process in kidney waiting list. The most common causes of transitory exclusion were: noncompliance (n=154, 44 %), cardiovascular disease (n=64, 18 %), obesity (n=53, 15 %, as defined by body mass index [BMI]> or = 30), miscellaneous (n= 29, 8 %), social (n=26, 7 %), infectology disease (n=14, 4 %). Conclusion: Only 12% of the patients refered to transplant evaluation were included on the waiting list. Actions were taken as the realization of clinical interviews and sequential follow-up studies to optimize the resources, to improve the information to the patients and compliance to evaluation.

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