Abstract: FR-PO1174
Sex Differences in Multimorbidity Clusters in Kidney Transplant Patients: Data from a Multicentre Trial
Session Information
- Transplantation: Clinical - Post-Transplant Complications
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1901 Transplantation: Basic
Authors
- Lightfoot, Courtney J., University of Leicester, Leicester, United Kingdom
- Wilkinson, Thomas James, University of Leicester, Leicester, United Kingdom
- Smith, Alice C., University of Leicester, Leicester, United Kingdom
Background
Multimorbidity is a complex phenomenon which is highly prevalent in patients with chronic kidney disease (CKD). Comorbidities can create a ‘treatment burden’ and specific combinations of conditions may have greater effects on functional status, quality of life, and mortality than others. Before determining the impact of multiple chronic conditions on kidney transplant recipients, the patterns of multimorbidity disease need to be identified.
Methods
Data was derived from a cross-sectional multicentre survey study. Principal Components Analysis (PCA) (orthogonal (varimax) rotation with a minimum factor loading of .40) was used to identify multimorbidity clusters for both sexes. The number of components (‘clusters’) was determined by the Eigenvalue of >1 or visual interpretation of the scree plot.
Results
Data from 2240 transplant patients [age: 52.6 (13.6) years; males: 1289 (58%); white: 1503 (67%); total number of additional (to CKD) comorbidities: 1.35 (1.1); cadaver donor grafts: 1077 (48%); months with transplant: 71.0 (85.2)] were collected from 17 geographically diverse transplant centres.
Five multimorbidity clusters were identified for males, and three for females, which are displayed in Figure 1. For males, one cluster included cardiopulmonary diseases; in females this cluster also included musculoskeletal conditions. In females, hypertension clustered with diabetes, whereas in males it was a standalone condition.
Conclusion
Patterns of comorbidities are different between male and female transplant patients, and include concordant (i.e. sharing common pathophysiological pathway with CKD (e.g. diabetes)) and discordant conditions (i.e. not sharing common pathway with CKD (e.g. depression)). Recognition of multimorbidity clusters may help identify patients at risk of co-occurring diseases. This may favour a more patient-orientated management strategy to reduce treatment burden and improve quality of life. Further research is needed to enhance the understanding of the identified clusters to improve the management of multimorbid kidney transplant recipients.
Funding
- Private Foundation Support