Factors That May Influence Estimated Glomerular Filtration Rate in Patients With Excellent Graft Function 10 Years Posttransplant

Abstract

BackgroundDonor age, cold ischemia time, delayed graft function (DGF), prior sensitization, HLA mismatches, acute rejection episodes, glomerular disease and viral nephropathy are some factors that shorten graft survival. Patients with excellent graft function at 10 years posttransplant have probably successfully overcome these detrimental factors. The effect of initial functional renal mass is probably associated with this outcome. The objective of the present study was to identify factors that show predictive value for the population of patients with excellent graft function at 10 years posttransplantation. Patients and methodsThis retrospective observational study included 117 patients transplanted from deceased donors. They all presented glomerular filtration rates (GFR) ≥ 40 mL/min. They were stratified as group I (n = 56) estimated GFR ≥ 40 <60 mL/min versus group II (n = 61) estimated GFR ≥ 60 mL/min. We analyzed the variables of donor age, recipient age and gender, DGF, immunosuppression, obesity, acute rejection episodes, HLA mismatches, panel-reactive antibodies and the mean estimated GFR at 1, 5, and 10 years posttransplant. ResultsDonor age and patients with DGF were significantly different between the two groups upon univariate analysis. Multivariate logistic regression analysis showed only donor age to be independently associated with an eGFR < 60 mL/min at 10 years. In both groups a decrease of eGFR > 10 mL/min between the 1st and the 10th year correlated significantly with donor age (P = .04). The deterioration of graft function was greater among group I than group II (6.7 vs 0.23 mL/min; P = .007). ConclusionDonor age was the most significant predictive factor for graft function at 10 years.