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Kidney Week

Abstract: SA-PO028

History of Posttraumatic Stress Disorder, and Mortality After Kidney Transplantation

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Siwakoti, Ashmita, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Potukuchi, Praveen Kumar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Gaipov, Abduzhappar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Talwar, Manish, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Balaraman, Vasanthi, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Chakravarty, Arijit, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Streja, Elani, University of California Irvine, School of Medicine, Orange, California, United States
  • Eason, James D., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
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