Fluctuation of Renal Function During the First Year Is Associated with Negative Impact on Long-Term Kidney Graft Survival: A Retrospective, Propensity Score-Matched Study.
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
3The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
4Department of Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.
Meeting: 2016 American Transplant Congress
Abstract number: A240
Keywords: Glomerular filtration rate (GFR), Graft failure, Graft survival, Renal dysfunction
Session Information
Date: Saturday, June 11, 2016
Session Name: Poster Session A: Long Term Outcomes in Kidney Transplantation
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background: Post-transplant renal function in the first year has been reported to predict long-term renal graft survival. The present study examined whether the fluctuation of post-transplant renal function during the first year is also an important risk factor for long-term graft survival of kidney transplantation (KT) patients.
Methods: We reviewed 3,026 adult recipients who underwent KT in single center between April 1979 and November 2012. The present retrospective, longitudinal study using propensity score matching technique was conducted to compare graft survival between recipients with or without fluctuation of renal function (fluctuation group was defined as recipients who had at least one more episodes of estimated glomerular filtration rate (eGFR) decline more than 25% at every 3 months interval during 1 year after KT). Individuals from the fluctuation and control group were matched in a 1:3 ratio with respect to the propensity score. Covariates in our Propensity score model included donor and recipient age and sex, human leukocyte antigen (HLA) mismatch, acute rejection status, hepatitis, diabetes, donor type, and immunosuppressant.
Results: After propensity score matching, 344 and 1032 cases were assigned into the fluctuation group and the control group, respectively. Mean eGFR at 1 year after KT was significantly lower in the fluctuation group than the control group (55.6±20.1 ml/min/1.73m2 vs. 67.8±18.7 ml/min/1.73m2, p=0.021). Graft survival rate estimated by Kaplan-Meier estimator was significantly lower in the fluctuation group (log-rank test p<.001).
The multivariable Cox regression adjusting donor and recipient age, HLA mismatch, acute rejection status, donor type and eGFR at 1year after KT showed that fluctuation of renal function has the significant association with higher graft failure (HR= 1.623, p<.001).
Conclusion: Our data support that the fluctuation of renal function during the first year after KT is associated with poor outcome for long-term kidney graft survival.
CITATION INFORMATION: Choi H, Joo D, Song M, Kim M, Kim Y, Kim B. Fluctuation of Renal Function During the First Year Is Associated with Negative Impact on Long-Term Kidney Graft Survival: A Retrospective, Propensity Score-Matched Study. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Choi H, Joo D, Song M, Kim M, Kim Y, Kim B. Fluctuation of Renal Function During the First Year Is Associated with Negative Impact on Long-Term Kidney Graft Survival: A Retrospective, Propensity Score-Matched Study. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/fluctuation-of-renal-function-during-the-first-year-is-associated-with-negative-impact-on-long-term-kidney-graft-survival-a-retrospective-propensity-score-matched-study/. Accessed November 17, 2019.« Back to 2016 American Transplant Congress