Survival of Renal Transplantation Patients Older Than 60 Years: A Single-Center Experience

Ceballos, Joaquín Rodelo; Nieto­-Ríos, John Fredy; Higuita, Lina María Serna; Henao, Jorge; García, Á.; Reino, A.; Tobón, Juan Carlos Jiménez; Arbelaez, Mario

doi:10.1016/j.transproceed.2012.10.053

Cited by 9 publications

(4 citation statements)

References 43 publications

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“…Consequently, only 2.6% of the transplantations were performed in older people. Although older age has been identified as a risk factor for graft loss in this and other studies (26,37,40) , some authors have questioned this assumption and have reported that the survival rates of patients aged <50 years were similar to those of patients aged >50 years (12,41). As a result, we believe age should not necessarily be a discriminatory factor against receiving a transplant.…”

Section: Discussionmentioning

confidence: 52%

Ten-year kidney transplant survival of cyclosporine- or tacrolimus-treated patients in Brazil

Gomes

Júnior

Lemos

et al. 2016

Expert Review of Clinical Pharmacology

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Section: Discussionmentioning

confidence: 52%

Ten-year kidney transplant survival of cyclosporine- or tacrolimus-treated patients in Brazil

Gomes

Júnior

Lemos

et al. 2016

Expert Review of Clinical Pharmacology

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“…44 Consistent with these observations, we previously reported that the leading causes of death in kidney transplant recipients older than 60 years were CVD (38.2%), and infections (33.8%). 45 In SLE patients, life expectancy has improved over the last five decades, leading to longer disease duration and, thus, to the occurrence of different comorbidities, including CVD, malignancy, infection, and ESKD. 46 In our cohort, older age was expected to be a predictor of a poor patient and death-censored graft survival for several reasons: firstly, the absolute risk of CVD among SLE patients increases with age; 46 secondly, CVD was the second most common cause of death after infections; thirdly, 61% of the deceased recipients died with a functional graft, and 30% of these deaths were attributed to CVD; lastly, recipient age (HR, 1.7 per 10-yearincrease; 95% CI, 1.09-1.25) was found to be a risk factor for 1-year graft loss after kidney transplantation in a recent meta-analysis, which is consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

Kidney transplantation outcomes in lupus nephritis: A 37-year single-center experience from Latin America

Rodelo

González

Ustáriz

et al. 2021

Lupus

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Objective We assessed patient and graft outcomes and prognostic factors in kidney transplantation in patients with end-stage kidney disease (ESKD) secondary to lupus nephritis (LN) undergoing kidney transplantation from August 1977 to December 2014 in a Latin American single center. Methods The primary endpoint was patient survival, and the secondary endpoints were death-censored graft survival for the first renal transplant and the rate of recurrent LN (RLN). Kaplan–Meier method was used for survival analysis. Factors predicting patient and death-censored graft survivals were examined by Cox proportional-hazards regression analyses. Results 185 patients were retrospectively evaluated. Patient survival rates were 88% at one year, 82% at three years, 78% at five years, and 67% at ten years. Death-censored graft survival for the first renal transplant was 93% at one year, 89% at three years, 87% at five years, and 80% at ten years. RLN was diagnosed in 2 patients (1.08%), but no graft was lost because of RLN. Thirty-nine (21.1%) patients died, and 65 (35.1%) patients experienced graft loss during the follow-up. By multivariable analyses, older recipient age and 1-month posttransplantation eGFR <45 ml/min/1.73m2 were associated with lower patient survival and an increased risk of graft loss, while induction immunosuppressive therapy exerted a protective effect on patients’ survival. In the subgroup of patients in whom disease activity was measured at the time of transplantation, a higher SLEDAI score was also associated with lower patient survival and an increased risk of graft loss. Conclusion In a mostly Mestizo population, kidney transplantation is an excellent therapeutic alternative in LN patients with ESKD. Older recipient age, an eGFR <45 ml/min/1.73m2 at one month posttransplantation, and disease activity at the time of transplantation are predictive of a lower patient and death-censored graft survival, while induction immunosuppressive therapy has a protective effect on patient survival. RLN is rare and does not influence the risk of graft loss.

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“…Retrospective data shows a negative impact of diabetes on LOS12 and infection 3. There are conflicting data, especially, regarding graft outcomes and mortality 13,14. One prospective study by Hermayer et al15 (n=104) attempted to address whether intensive blood glucose control (70−110 mg/dL) or standard blood glucose control (70−180 mg/dL), in patients with diabetes or impaired glucose tolerance, affected delayed graft function.…”

Section: Discussionmentioning

confidence: 99%

Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation

Lamos

Wijesinha

Ramhmdani

et al. 2017

DMSO

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ObjectiveTo compare length of stay (LOS) and incidence of hypoglycemic events and infections in hospitalized patients with diabetes mellitus (DM) undergoing renal transplantation, among groups of patients defined by admission glucose and mean inpatient daily glucose.MethodsA retrospective analysis of 190 charts of patients with DM who underwent renal transplantation over a 2-year period was conducted. Patients were grouped according to admission glucose and mean inpatient daily glucose (≤140 mg/dL, 141–180 mg/dL, and >180 mg/dL).ResultsAdmission glucose was not associated with LOS. A mean inpatient daily glucose of ≤140 mg/dL was associated with a longer LOS compared to a mean inpatient daily glucose of >180 mg/dL (p=0.03). Patients with an admission glucose of ≤140 mg/dL had approximately half the rate of hypoglycemic events compared to those with admission glucose of 141−180 mg/dL (odds ratio [OR]=2.1; p=0.02) or >180 mg/dL (OR=1.9; p=0.04). However, patients whose mean daily glucose was ≤140 mg/dL had approximately twice the rate of hypoglycemic events than those whose mean daily glucose was 141−180 mg/dL (OR=0.4; p=0.01) or >180 mg/dL (OR=0.4; p=0.004). The incidence of infections was low and was not associated with admission or mean daily glucose levels.ConclusionLower mean daily inpatient glucose levels (≤140 mg/dL) are associated with longer LOS and greater incidence of hypoglycemic episodes in diabetes patients undergoing renal transplantation. Our findings suggest that target blood glucose levels of 140−180 mg/dL may be appropriate in this specific population. Additional prospective research is needed to confirm these findings.

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Survival of Renal Transplantation Patients Older Than 60 Years: A Single-Center Experience

Cited by 9 publications

References 43 publications

Ten-year kidney transplant survival of cyclosporine- or tacrolimus-treated patients in Brazil

Ten-year kidney transplant survival of cyclosporine- or tacrolimus-treated patients in Brazil

Kidney transplantation outcomes in lupus nephritis: A 37-year single-center experience from Latin America

Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation

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