Abstract
Background: Factors influencing the kidney function of patients after renal transplantation include both recipient-related factors and donor-related factors. To gain a better understanding of these factors and to improve clinical decision-making, we performed a retrospective study of southwestern Chinese people receiving kidney transplantation.Methods: In this retrospective analysis, a total of 2,462 recipients receiving allogeneic kidney transplantation in West China Hospital of Sichuan University from December 13, 2008 to January 10, 2018 were included. Data on recipient and donor characteristics were extracted from the Transplant Center Database and stratified by discrete time points after kidney transplantation. Univariate and multivariate logistic regression analyses were carried out on the study variables, and kidney function of postoperative patients was monitored using cystatin C (CysC) as the outcome indicator.Results: From the univariate analysis, several factors showed statistically significant short-term impact on kidney function based on CysC after kidney transplantation, including age, ethnicity, body mass index (BMI), and HLA A-B-DR-DQ loci mismatch. Gender of recipients and gender-consistency between donors and recipients revealed both short-term and long-term influence. Younger donors had significantly better medium-and-long-term influence on kidney function. From the multivariate logistic regression analysis, recipient gender, ethnicity, BMI, and donor age were independent factors affecting postoperative CysC recovery at discrete time points.Conclusion: Several factors of recipients related to renal function after kidney transplantation, such as gender, ethnicity, BMI and donor's age should be paid more attention to. Moreover, female and non-Han recipients decreased the risk of poor outcome during postoperative kidney function recovery while large BMI of recipients and higher donor age increased the risk. It is useful to predict the postoperative renal function earlier according to corresponding factors, and improve the patient's quality of life.
Highlights
Chronic kidney disease (CKD) is a great global health burden due to its high associated risk of end-stage renal disease (ESRD) [1] and ESRD has been reported to affect an estimated 7.4 million people worldwide [2]
The results showed that the recipient gender, ethnicity, body mass index (BMI), and donor age were independent factors affecting postoperative Cystatin C (CysC) recovery reflecting kidney function in renal transplant recipients (P < 0.05)
We identified recipient-related and donorrelated factors associated with influence on postoperative kidney function in kidney transplant recipients
Summary
Chronic kidney disease (CKD) is a great global health burden due to its high associated risk of end-stage renal disease (ESRD) [1] and ESRD has been reported to affect an estimated 7.4 million people worldwide [2]. In addition to increasing the quantity of kidney transplant procedures, improving the long-term survival rate of recipients and ensuring the quality of renal function after transplantation have become primary objectives for all transplant centers. Smaller recipients of larger donor kidneys have been linked to better long-term outcomes [10] This difference in BMI can reduce the possibility of graft loss for sex-mismatched recipients [11]. Due to increasing organ shortage during the last three decades, ABO incompatibility kidney transplantation has become a routine procedure and Abbreviations: CKD, chronic kidney disease; ESRD, end-stage renal disease; CysC, cystatin C; DCD, donor after cardiac death; eGFR, estimated glomerular filtration rate; Cr, creatinine; BMI, body mass index. To gain a better understanding of these factors and to improve clinical decisionmaking, we performed a retrospective study of southwestern Chinese people receiving kidney transplantation
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