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Kidney Week

Abstract: FR-PO1197

CKD Progression Rate from Stage 4 to 5 Is Faster in Kidney Allograft Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Eyupoglu, Sahin, Ankara University School of Medicine, Ankara, Turkey, Turkey
  • Kumru, Gizem, Ankara University School of Medicine, Ankara, Turkey, Turkey
  • Örs Şendoğan, Damla, Ankara University School of Medicine, Ankara, Turkey, Turkey
  • Eren Sadioglu, Rezzan, Ankara University School of Medicine, Ankara, Turkey, Turkey
  • Kutlay, Sim, Ankara University School of Medicine, Ankara, Turkey, Turkey
  • Nergizoglu, Gokhan, Ankara University School of Medicine, Ankara, Turkey, Turkey
  • Erturk, Sehsuvar, Ankara University School of Medicine, Ankara, Turkey
  • Keven, Kenan, Ankara University School of Medicine, Ankara, Turkey, Turkey
Background

In kidney transplant recipients (KTR), average glomerular filtration rate (GFR) is around 55-70 ml/min in early period after transplantation. Although, chronic kidney disease progression (CKD) rates have been extensively studied in non-transplanted CKD patients, there are limited comparative studies in KTR. In this study, we aimed to evaluate whether CKD progression from stage 4 to 5 is different in KTR than those of CKD patients.

Methods

The study included 76 stable CKD patients and 34 stable RTR (24 living donor, 10 deceased donor) with stage 4 CKD who reached stage 5 during their follow-up between May 2017 and December 2018 in our hospital. Patients with graft loss due to early acute rejection, early graft loss due to surgical complications, immunosupressive non-compliant patients were excluded in KTR. In control, patients with rapidly progressive glomerulonephritis, acute kidney injury on chronic were excluded. CKD stage was determined according to Kidney/Disease Outcomes Quality Initiative staging system. The progression rate from stage 4 CKD to 5 was calculated retrospectively and compared through Kaplan-Meier analysis between groups. Also, clinical features which could contribute to disease progression were assessed and Cox regression analysis was performed for adjustment.

Results

The KTR were under triple immunosuppressive treatment including prednisolone, mycophenolate mofetil (azathioprine) and tacrolimus (cyclosporine). The average follow-up were 89±77 months in KTR. Median progression time in RTR patients was significantly shorter than CKD patients 18 (95% CI: 13.5-22.6) vs 38 (95% CI: 33.25-42.75) months, p= 0.017. GFR levels were 28.2 ml/min and 29.5 ml/min in KTR and CKD patients on stage 4, respectively. At the end GFR levels were 7.43 ml/min and 7.4 ml/min in KTR and CKD groups on stage 5. Male patients had shorter progression time than women (25 [%95CI: 22.1-27.8] vs 42 [95% CI:37.2-46.7] months p=0.01). After Cox regression analysis gender (p=0.016) and transplant status (p=0.015) remained their significance.

Conclusion

Progression time from stage 4 to 5 is shorter in RTR than native CKD patients. Gender and age also can contribute disease progression.