Kidney Week

Abstract: TH-PO1018

Clinical Outcomes of Kidney Transplantation vs. Conservative CKD Management in Older Adults: A Propensity Score-Matched Analysis

Session Information

• Transplantation: Clinical - Outcomes, Malignancy, and Pathology
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Lee, Yu ho, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)

Yu ho Lee, MD, PhD

• Lee, Jeong-Yeun, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)

Jeong-Yeun Lee, MD

• Yoon, Soo-Young, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)

Soo-Young Yoon, MD, PhD

• Kim, Jinsug, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)

Jinsug Kim, MD

• Jeong, Kyunghwan, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)

Kyunghwan Jeong, MD, PhD

• Hwang, Hyeon Seok, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)

Hyeon Seok Hwang, MD, PhD

Background

Although kidney transplantation is considered the optimal treatment for end-stage kidney disease (ESKD), its risks and benefits in the elderly remain unclear. This study compared clinical outcomes between kidney transplant recipients and propensity score–matched individuals aged ≥65 years.

Methods

Elderly kidney transplant recipients and matched population were obtained from the Korean Organ Transplant Registry (KOTRY) and a National Health Insurance Service-Elderly Cohort Database (NHIS-ECD), respectively. A 1:1 exact propensity score-matching was performed to account for differences in age, sex, and estimated glomerular filtration rate. The primary outcomes were all-cause mortality, hospitalization for infection, progression to ESKD, and cardiovascular disease.

Results

After 1:1 matching, 543 patients were included in each group. Elderly kidney transplant recipients had similar risks of all-cause mortality (adjusted hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.41–1.07) and cardiovascular disease (adjusted HR, 0.78; 95% CI, 0.27–2.23) compared with matched elderly. However, the risk of progression to ESKD was significantly higher in the transplant group (adjusted HR, 3.51; 95% CI, 1.07–11.5), and they also experienced more frequent infection-related hospitalizations (adjusted HR, 3.91; 95% CI, 2.66–5.74).

Conclusion

Among individuals aged ≥65 years, kidney transplantation was not associated with increased risks of all-cause mortality or cardiovascular disease compared with matched elderly, while conferring higher risks of kidney failure and infection-related hospitalization.