Background: A decrease in renal function is associated with an increased risk of cardiovascular disease, graft loss and mortality following renal transplantation. It is unclear whether decreased renal function is associated with an increased risk of hospitalization.

Methods: We examined adult (18+), first-time, KTx recipients from the United Network for Organ Sharing database between 2004-2005; we examined hospitalizations 1-year post-transplant. Longitudinal mixed models were used to explore the relationship between eGFR measured at 1 month, 3 months, and 6 months post-transplant, and the cumulative number of hospitalizations for the same period.

Results: KTx recipients (n=20,071) were hospitalized 0.80 (range=0-17) times on average within 1 year post-transplant. Among those hospitalized (n=14,632), the mean number of hospitalizations was 2.13. Mean hospitalizations increased monotonically with decreasing eGFR, where patients with an eGFR between 60-89 ml/min/1.73m2 had the fewest hospitalizations (0.6 hospitalizations), and those with an eGFR less than 15 ml/min/1.73m2, had the highest (2.3 hospitalizations). In crude models, a decrease in eGFR was significantly associated with an increase in the number of hospitalizations. For every 10 ml/min/1.73m2 decrease in eGFR, there was an increase of 0.03 hospitalizations (p <0.001). As mean 6-month eGFR decreased, the number of hospitalizations 1 year post-transplant increased.

For instance, there was a significant difference between mean eGFR at 6 months for individuals who were hospitalized one time (Mean = 58.16 ml/min/1.73m2) vs. those who were hospitalized at least 5 times post-transplant (Mean = 46.98 ml/min/1.73m2) (t = 10.07, p < 0.0001).

Conclusions: Decreasing eGFR is associated with an increase in the total number of hospitalizations among adult, first-time KTx recipients. Presented analyses are unadjusted; multivariable analyses are underway.

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