Renal allograft survival: Incidence and risk factors associated with graft dysfunction

Abstract

Background: Renal transplantation is considered the best available therapy for patients suffering from end-stage kidney disease. Improvement in allograft outcome, patient survival, and quality of life are the most important indicators of the effectiveness of renal transplantation. Short-term allograft survival has improved significantly, however, long-term allograft survival and associated risk factors need to be studied. Objectives: This single-center study aims to determine the incidence of long-term graft dysfunction (GD) and the associated risk factors among renal transplant recipients in Dubai Hospital, Dubai, United Arab Emirates. Materials and Methods: A single-center longitudinal cohort analysis of 506 renal transplant follow-up recipients' allograft functions was analyzed through a detailed chart review. We hypothesized that different recipients' characteristics such as age (present and age at the time of transplantation), gender, history of acute rejection, posttransplant viral infections (hepatitis B virus, hepatitis C virus [HCV], Cytomegalovirus, BK virus), and comorbid would affect allograft function in renal transplant recipients. Allograft dysfunction is defined as a 15%–20% increase in creatinine from baseline. We assessed the incidence of allograft dysfunction and associated risk factors. Results: The median age of transplant recipients and the age at the time of transplantation were 55 ± 21 and 39 ± 14.93 years, respectively. About 61.85% (n = 313) of the transplant population were males. The incidence of allograft dysfunction in the study period was 57.15%. In our study population, 1-, 5-, and 10-year graft survival rate was 98.62%, 82.35%, and 54.90%, respectively. Independent risk factors include age, male gender, history of acute rejection, HCV infection, and diabetes mellitus (DM). Posttransplant DM (PTDM) is not associated with GD. Conclusion: Allograft dysfunction is quite common among renal transplant recipients. Independent risk factors in our analysis include age, male gender, history of acute rejection, HCV infection, and DM. PTDM is not associated with GD.