Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Cognitive impairment is common in end-stage renal disease patients and impedes adherence to complex treatment regimens. Given the complexities of post-transplant immunosuppression, we hypothesized that cognitive impairment at transplant is associated with an increased risk of all-cause graft loss (ACGL) among kidney transplant (KT) recipients.
METHODS: Using the Modified Mini-Mental State (3MS) examination, we measured global cognitive function in a prospective cohort of 864 KT candidates (8/2009-7/2016). We estimated the association between pre-KT cognitive impairment and ACGL using Cox regression adjusting for recipient, donor, and transplant factors.
RESULTS: The prevalences of impairment (3MS<80) and severe impairment (3MS<60) were 6.6% and 3.3%, respectively, among living donor KT (LDKT) recipients and 12.4% and 2.6%, respectively, among deceased donor KT (DDKT) recipients. We estimated 11.7% (8.5-14.9%) of US KT recipients had pre-transplant cognitive impairment. LDKT recipients with impairment had higher ACGL risk than recipients without impairment (5-year ACGL: 45.5% vs. 10.6%, p<0.01; aHR impairment: 1.785.4016.34, p<0.01; aHR severe impairment: 1.295.5724.00, p=0.02) (Figure 1). DDKT recipients with severe impairment had higher ACGL risk than recipients without severe impairment (5-year ACGL: 53.0% vs. 24.2%, p=0.04; aHR severe impairment: 1.132.927.50, p=0.03) (Figure 2).
CONCLUSIONS: Given the prevalence of cognitive impairment and the associated elevated ACGL risk, pre-KT screening for impairment is warranted to identify higher-risk KT recipients.
CITATION INFORMATION: Thomas A., Ruck J., Shaffer A., Haugen C., Ying H., Warsame F., Chu N., Carlson M., Gross A., Norman S., Segev D., McAdams-DeMarco M. Cognitive Impairment and Graft Loss in Kidney Transplant Recipients Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Thomas A, Ruck J, Shaffer A, Haugen C, Ying H, Warsame F, Chu N, Carlson M, Gross A, Norman S, Segev D, McAdams-DeMarco M. Cognitive Impairment and Graft Loss in Kidney Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/cognitive-impairment-and-graft-loss-in-kidney-transplant-recipients/. Accessed November 19, 2019.
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