Kidney Week

Abstract: TH-PO1133

Kidney Function, Albuminuria, and the Risk of Hemorrhage and Thrombosis After Kidney Transplantation

Session Information

• Transplantation: Clinical - Predictors of Outcomes - Biomarkers and Beyond
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• Jeong, Rachel H., University of Alberta, Edmonton, Alberta, Canada

Rachel H. Jeong,

• Quinn, Robert R., University of Calgary, Calgary, Alberta, Canada

Robert R. Quinn,

• Ravani, Pietro, University of Calgary, Calgary, Alberta, Canada

Pietro Ravani,

• Sood, Manish M., Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

Manish M. Sood,

• Tonelli, Marcello, University of Calgary, Calgary, Alberta, Canada

Marcello Tonelli,

• Ye, Feng, University of Alberta, Edmonton, Alberta, Canada

Feng Ye,

• Hemmelgarn, Brenda, University of Calgary, Calgary, Alberta, Canada

Brenda Hemmelgarn,

• Massicotte-Azarniouch, David, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

David Massicotte-Azarniouch,

• Lam, Ngan, University of Alberta, Edmonton, Alberta, Canada

Ngan Lam,

Background

Compared to the general population, kidney transplant recipients are at increased risk of hemorrhage and thrombosis. Whether this risk is affected by kidney function and albuminuria is unknown.

Methods

We conducted a retrospective cohort study using linked healthcare databases to identify adult kidney transplant recipients from 2002-2015 in Alberta, Canada. Estimated glomerular filtration rate (eGFR) and albuminuria measurements at 1-year posttransplant were used to categorize recipients (eGFR: ≥45 vs. <45 mL/min/1.73 m²; albuminuria: normal vs. mild-heavy). We determined the association between categories of eGFR and albuminuria and posttransplant hemorrhage and venous thrombosis based on diagnostic and procedural codes.

Results

Of 1,284 kidney transplant recipients at 1-year posttransplant, 21% had an eGFR <45 mL/min/1.73 m² and 40% had mild-heavy albuminuria. The mean age of the cohort was 53 years [IQR 41-62]. Previous thrombosis was higher in recipients with lower eGFR, but previous hemorrhage was similar across all groups. Over a median follow-up of 6 years, the age- and sex-adjusted rate of hemorrhage and thrombosis was over 2-fold higher in recipients with lower eGFR and mild-heavy albuminuria compared to recipients with higher eGFR and normal albuminuria (hemorrhage: incidence rate ratio, IRR, 2.6, 95% CI 1.5-4.4, p=0.001; thrombosis: IRR 2.3, 95% CI 1.1-5.0, p=0.046).

Conclusion

Among kidney transplant recipients at 1-year posttransplant, the risk of hemorrhage and venous thrombosis is higher with lower eGFR and mild-heavy albuminuria. Thus, eGFR and degree of albuminuria may help prognosticate kidney transplant recipients long-term.

Adjusted Incidence Rate Ratios by Level of eGFR and Albuminuria in Recipients