Abstract: TH-PO1001

Impact of Elevated PSA on Time to Kidney Transplant and Mortality in ESRD Patients

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Sarabu, Nagaraju, University Hospitals Case Medical Center, Rocky River, Ohio, United States
  • Schiltz, Nicholas K, Case Western Reserve University, Cleveland, Ohio, United States
  • Hricik, Donald E., University Hospitals Case Medical Center, Rocky River, Ohio, United States
Background

Conflicting opinions and practices exist about screening for prostate cancer prior to kidney transplant with a PSA because of the concern that it might delay transplant causing more harm than benefit.

Methods

This study included incident male ESRD patients over 45 years from the 1999-2012 United States Renal Data System, linked with Medicare claims data. Our main study variable of interest was elevated prostate specific antigen (PSA) as indicated through an ICD-9-CM diagnosis code. Primary outcomes of interest were time to kidney transplant and mortality. We used propensity score matching to control for selection bias, and Cox proportional hazards models and Kaplan Meier curves to compare the risk between men with elevated and non-elevated PSA.

Results

2789 of 64307 (4.3%) of the patients had elevated PSA. Figure 1 shows the baseline characteristics of 2789 patients with elevated PSA and 2789 propensity based matched controls. Elevated PSA was associated with lesser mortality (HR:0.66; CI: 0.62-0.70), and did not significantly increase time to transplant (HR: 0.80; CI: 0.80-1.06). Kidney transplant significantly improved survival regardless of the PSA status prior to transplant.

Conclusion

Elevated PSA is not a contraindication for kidney transplant, and therefore should not be delayed.

Baseline characteristics of propensity matched groups

Kidney Transplant Improves Survival regardless of PSA status