Risk Factors and Expected Clinical Outcomes in Kidney Transplantation Based on 1 Year Serum Creatinine Levels

Abstract

Background: This retrospective study delineates the variable risk factors associated with differences in renal function at 1 year post kidney transplantation. Materials and Methods:<b> </b>Two hundred and eighty four<b> </b>kidney transplant patients were reviewed and divided into 4 groups according to serum creatinine levels 1 year post kidney transplantation: serum creatinine levels < 1 mg/dl (Group I; 65 patients), serum creatinine between 1 and 1.51 mg/dl (Group II; 173 patients), serum creatinine between 1.51 and 2mg/dl (Group III; 37 patients) and serum creatinine > 2mg/dl (Group IV; 9 patients). Baseline demographics and variable risk factors in both donors and recipients were analyzed. Results:<b> </b>Baseline demographics of all groups were similar, including: recipient age, cause of the original kidney disease, dialysis duration, HLA matching, induction therapy, rate of acute rejection as well as the pre and 1 year post transplant diabetes, hypertension and lipid profile. However, there were significant differences between the groups according to: donor age, donor and recipient gender, maintenance immunosuppression therapy, recipient sensitization and the severity of acute rejection episodes. The rate and type of In Hospital infections, the duration of hospital stay, the occurrence of delayed graft function, the rate and type of surgical complications at 1 year as well as the serum creatinine levels upon discharge and at 1, 3 and 6 months were significantly different between the 4 groups. Conclusion:<b> </b>Serum creatinine level post-transplantation is a powerful predictor of long term graft survival. Although some risk factors associated with graft survival are fixed, others can be optimized.