Outcomes of Kidney Transplantation in Patients with Congenital Anomalies of the Kidney and Urinary Tract

O. A. Oto¹, Y. Caliskan², H. Yazici¹, S. Mirioglu³, A. Dirim¹, N. Garayeva¹, S. Safak¹, E. Demir¹, Y. Ozluk⁴, A. Artan¹, A. Turkmen¹, K. Lentine²

¹Nephrology, Istanbul University, Istanbul, Turkey, ²Nephrology, Saint Louis University School of Medicine, Saint Louis, WA, ³Nephrology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey, ⁴Pathology, Istanbul University, Istanbul, Turkey

Meeting: 2021 American Transplant Congress

Abstract number: 1056

Keywords: Graft survival, Kidney transplantation

Topic: Clinical Science » Kidney » Kidney Complications: Non-Immune Mediated Late Graft Failure

Session Information

Session Name: Kidney Complications: Non-Immune Mediated Late Graft Failure

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: We aimed to compare the long-term outcomes after kidney transplantation (KTx) in patients with congenital anomalies of the kidney and urinary tract (CAKUT) versus non‐CAKUT causes of kidney failure.

*Methods: For this observational study, 495 prevalent KTx recipients (59% male) were classified into two groups: Patients with CAKUT (n= 175) and non-CAKUT (n= 320). Baseline demographic, clinical and laboratory characteristics, as well as follow-up outcomes, were analyzed. The primary outcome was allograft loss defined as the return to dialysis or transplantation.

*Results: Patients were followed for a median of 136 (86-176) months after KTx. The study groups were similar regarding recipient gender, donor age, donor type, donor gender, HLA matching, levels of pretransplant panel reactive antibody and type of maintenance immunosuppressive treatment regimens. Recipient median age was significantly lower [25.5 (20.0-30.0) vs 31.0 (25.0-39.0), p<0.001] in the CAKUT group compared to the non-CAKUT group. Groups were comparable in post-KTx events including rejection rates, types of rejection. The incidence of urinary tract infection was significantly higher in the CAKUT group than in the non-CAKUT group (20.6% vs 10.0%, p=0.003). Median eGFR on last follow up was significantly higher in the CAKUT group [62.0 (33.6-90.6) mL/min/1.73m²] compared to non-CAKUT [46.0 (12.6-73.5) mL/min/1.73m²] group (p<0.001). The rate of graft loss was significantly lower in the CAKUT group (16.0%) compared to non-CAKUT controls (32.0%) (p<0.001). Kaplan Meier survival analysis revealed a better 10-year unadjusted survival rate for the CAKUT group than the non-CAKUT group (p=0.015) (Fig. 1). In univariate Cox-regression analysis, it was found that the presence of CAKUT significantly reduced the risk of graft loss (HR: 0.651, CI 95% 0.460-0.92, p=0.015). Even though this predictive effect suggested a mild trend in multivariate analysis performed with potential confounding factors such as age and pretransplant dialysis duration, it did not reach statistical significance (HR: 0.714, CI 95% 0.479-1.065, p=0.099).

*Conclusions: This study suggest the favorable post-KTx course of patients with CAKUT compared to patients with kidney diseases of other etiologies.

To cite this abstract in AMA style:

Oto OA, Caliskan Y, Yazici H, Mirioglu S, Dirim A, Garayeva N, Safak S, Demir E, Ozluk Y, Artan A, Turkmen A, Lentine K. Outcomes of Kidney Transplantation in Patients with Congenital Anomalies of the Kidney and Urinary Tract [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-kidney-transplantation-in-patients-with-congenital-anomalies-of-the-kidney-and-urinary-tract/. Accessed May 16, 2025.

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