Kidney Week

Abstract: SA-PO028

History of Posttraumatic Stress Disorder, and Mortality After Kidney Transplantation

Session Information

• Transplantation: Clinical Outcomes
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Miklos Zsolt Molnar,

• Siwakoti, Ashmita, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Ashmita Siwakoti,

• Potukuchi, Praveen Kumar, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Praveen Kumar Potukuchi,

• Gaipov, Abduzhappar, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Abduzhappar Gaipov,

• Talwar, Manish, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Manish Talwar,

• Balaraman, Vasanthi, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Vasanthi Balaraman,

• Chakravarty, Arijit, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Arijit Chakravarty,

• Streja, Elani, University of California Irvine, School of Medicine, Orange, California, United States

Elani Streja,

• Eason, James D., University of Tennessee Health Science Center, Memphis, Tennessee, United States

James D. Eason,

• Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States

Kamyar Kalantar-Zadeh,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

Background

History of posttraumatic stress disorder (PTSD), if uncontrolled, represents a relative contraindication for kidney transplantation. However, no previous large study assessed the association between pre-transplant history of PTSD and post-transplantation outcomes.

Methods

We examined 4,479 US veterans who underwent kidney transplantation. The diagnosis of history of PTSD was based on a validated algorithm. Associations between pre-transplantation PTSD and all-cause mortality was examined in unadjusted and multivariable adjusted Cox proportional regression models.

Results

From among 4,479 veterans, 282 (6.3%) had a history of PTSD. The mean±SD age of the cohort at baseline was 61±11 years, 91% were male, 66% and 28% of patients were white and African-American, respectively and 31% received living transplantation. Compared to patients without history of PTSD, patients with a history of PTSD had similar risk of all-cause death [Hazard Ratio (HR) (95% Confidence Interval (CI)): 1.12 (0.82-1.51)] in our unadjusted model as shown in Figure 1. After adjustment for socio-demographic, comorbidity, medication, dialysis and transplant related variables there was no association between history of PTSD and all-cause mortality [HR (95%CI): 1.17 (0.83-1.65)].

Conclusion

After careful selection, pre-transplantation PTSD does not appear to be associated with higher mortality in kidney transplant recipients.

Figure 1: Probability of Death in Recipients with and without PTSD

Funding

• NIDDK Support