Abstract: TH-OR014
Factors Associated with Recovery of Kidney Function After Dialysis-Requiring AKI (AKI-D) Among Kidney Transplant Recipients
Session Information
- AKI Across the Care Continuum: From Detection to Recovery
October 22, 2026 | Location: Room 203, Convention Center
Abstract Time: 05:10 PM - 05:20 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Huang, (Jess) Jia Xin, University of California San Francisco School of Medicine, San Francisco, California, United States
- Glidden, David V., University of California San Francisco School of Medicine, San Francisco, California, United States
- Ku, Elaine, University of California San Francisco School of Medicine, San Francisco, California, United States
Background
Kidney transplant recipients (KTRs) are highly susceptible to AKI-D due to reduced nephron reserve, immunosuppression, and calcineurin inhibitor exposure. Factors associated with recovery of kidney function after AKI-D in KTRs remain poorly defined.
Methods
We used a national transplant registry to identify adults with Medicare who received a kidney transplant and developed AKI-D during a hospitalization (2006-2022). AKI-D was identified using dialysis procedural claims and a concurrent diagnosis code for acute kidney injury during hospitalization. The primary outcomes were recovery of kidney function, graft failure, or death within 30-days of AKI-D. Multinomial logistic regression was used to examine factors predictive of recovery of kidney function.
Results
Among 8124 KTRs with AKI-D, 3268 (40%) recovered kidney function, 3095 (38%) developed graft failure, and 1761 (22%) died within 30 days. Among survivors, the adjusted odds of recovery (vs graft failure) were 1.12 (95% CI 1.07-1.16) per 10-year increase in age (Table 1). Among survivors, Non-Hispanic Black patients had an 18% lower odds of recovery (95% CI 8%-27%) compared to Non-Hispanic White patients. None of the comorbidities (coronary artery disease, diabetes mellitus, heart failure, liver disease, peripheral vascular disease, prior stroke) were associated with the odds of recovery of kidney function.
Conclusion
Among KTRs with AKI-D, recovery of kidney function at 30 days was common (40%) and comparable to that in the general AKI-D population (41%) during short-term follow-up. Recovery was not uniform, with lower likelihood observed among younger patients and non-Hispanic Black recipients, while comorbidities were not predictive. These findings highlight the need for improved risk stratification and strategies to promote recovery in high-risk transplant populations.