Abstract: FR-PO1171
Assessing the Relationship Between Gout and Return to Hemodialysis Among Renal Transplant Patients
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
- 1902 Transplantation: Clinical
Authors
- Li, Justin W., Trinity Partners, Waltham, Massachusetts, United States
- Wang, Zheng, Trinity Partners, Waltham, Massachusetts, United States
- Yin, David, Trinity Partners, Waltham, Massachusetts, United States
- Brigham, Mark D., Trinity Partners, Waltham, Massachusetts, United States
- LaMoreaux, Brian, Horizon Therapeutics plc, Lake Forest, Illinois, United States
- Kent, Jeffrey, Horizon Therapeutics plc, Lake Forest, Illinois, United States
- Francis-Sedlak, Megan, Horizon Therapeutics plc, Lake Forest, Illinois, United States
- Johnson, Richard J., University of Colorado Denver, Aurora, Colorado, United States
- Hadker, Nandini, Trinity Partners, Waltham, Massachusetts, United States
- Miyasato, Gavin, Trinity Partners, Waltham, Massachusetts, United States
Background
Although gout has been shown to be associated with poor renal outcomes among chronic kidney disease populations, this relationship is not well understood among renal transplant recipients. This analysis compared rates of return to maintenance hemodialysis, a negative transplant outcome, across three primary renal transplant patient cohorts based on gout status: non-gout, pre-existing gout, and new-onset gout.
Methods
This retrospective study of the United States Renal Data System examined Medicare beneficiaries that received a primary renal transplant between 2008-2013. Patients’ Medicare claims data were used to identify pre-existing gout in the 2 years prior to transplant and new-onset gout in the 3 years post-transplant. To mitigate the effect of complications associated with acute allograft rejection/ failure, recipients who died, returned to dialysis, or received re-transplantation within 3 years after primary renal transplantation were excluded. Patients’ return to hemodialysis was observed in the period between 3-5 years post-transplantation. The association between gout status (non-gout, pre-existing, and new-onset) and 5-year return to dialysis was evaluated via chi-squared tests.
Results
39,780 patients received a primary renal transplant between 2008-2013 with Medicare as their primary payer after exclusions. Of these patients, 33,105 (83.2%) were non-gout, 4,747 (11.9%) had pre-existing gout, and 1,928 (4.8%) developed new onset gout post-transplant. 2,211 (5.6%) primary renal transplant recipients returned to hemodialysis 3 to 5 years post-transplantation. The rate of return to hemodialysis 3 to 5 years after transplantation for non-gout, pre-existing gout, and new onset gout was 5.6, 4.6, and 7.5%, respectively (all pairwise comparisons yielded p<0.05).
Conclusion
Compared to non-gout and pre-existing gout patients who received a primary renal transplant, patients who developed new-onset gout after transplantation were more likely to require maintenance hemodialysis, a negative renal transplant outcome. Further investigation is needed to determine if the presence, timing, and duration of gout relative to renal transplantation are independent predictors for return to dialysis.
Funding
- Commercial Support –