Abstract: SA-PO315
Clinical Conditions After Transplant Allograft Failure (TAF) and Return to Dialysis in Latin America: Can We Do Better?
Session Information
- Hemodialysis and Frequent Dialysis: Potpourri
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Guinsburg, Adrian M., Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Diaz Bessone, Maria Ines, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Berbessi, Juan Carlos, Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
- Hippen, Benjamin E., Fresenius Medical Care Global Medical Office, Waltham, Massachusetts, United States
Background
Dialysis (dial) initiation with permanent access and in-target clinical parameters for patients (pts) returning to dial after TAF are less frequently achieved than in incident dial population, even though transplanted pts usually enjoy specialist care. We aimed to compare baseline characteristics between TAF and native kidney failure pts (NKF) incident to dial in Fresenius Medical Care Latin America clinics
Methods
We selected all incident pts between Jan 2017 and Dec 2021. Pts were classified as TAF or NKF according to ESRD cause reported. Baseline parameters were collected within 30 days of dial initiation. Values expressed as mean±SD. Means compared using Student t-test for normal or Mann-Whitney for non-normal distributed variables
Results
We selected 56,247 new pts from which 34,630 were incident to dial: NKF 34,000 (98.2%), TAF 630 (1.8%). TAF were younger (46.2±16 vs 59.2±16 yrs; p<0.0001), had lower diabetes prevalence (10.3% vs 36.8%; p<0.0001), were more likely to start PD and had lower CVC prevalence. TAF had higher creatinine (Cr) (7.1±3.0 vs 6.7±3.1 mg/dl; p 0.02) at start, lower hb (8.9±1.9 vs 9.4±1.8 g/dl), higher ferritin (787±603 vs 461±466 ng/ml; p<0.0001) , TSAT (26.9±15.6 vs. 24±12.9%), CRP (22.2±22.7 vs 18.8±22.2 mg/l; p 0.01) and iPTH (533±552 vs 306±337 pg/ml), and were less likely to use ESA or iron therapy. AVF/AVG prevalence was higher in TAF but 30.7% started dial with a CVC (Table 1)
Conclusion
In our cohort, pts with TAF were younger and had lower prevalence of diabetes. At initiation, Cr was higher and Hb was lower in TAF group, indicative of delay in dial initiation and suboptimal pre-ESRD anemia management. Despite lower observed CVC prevalence in TAF, nearly one-third of pts with TAF started dial with a CVC
Table 1