Risk factors for hospitalizations resulting from pulmonary embolism after renal transplantation in the United States.
BACKGROUND
Risk factors for pulmonary embolism (PE) have been identified in the general population but have not been studied in a national population of renal transplant recipients.


METHODS
Therefore, 33,479 renal transplant recipients in the United States Renal Data System from 1 July 1994-30 June 1997 were analyzed in a historical cohort study of hospitalized PE (ICD9 Code 415.1x). HCFA form 2728 was used for comorbidities.


RESULTS
Renal transplant recipients had an incidence of PE of 2.26 hospitalizations per 1000 patient years at risk. In multivariate analysis, polycystic kidney disease (adjusted odds ratio, 4.44, 95% confidence interval, 2.31-8.53), older recipient age, higher recipient weight, cadaveric donation, history of ischemic heart disease, and decreased serum albumin were associated with increased risk of PE. Body mass index and hemoglobin were not significant. Kidney-pancreas transplantation was also not significant. In Cox Regression analysis PE was associated with increased mortality (hazard ratio 2.06, 95% CI 1.34-3.18).


CONCLUSIONS
The most important risk factors for PE in this population were polycystic kidney disease, advanced age and increased weight. The reasons for the increased risk of polycystic kidney disease remain to be determined but were independent of hematocrit level at initiation of end stage renal disease, and may result from venous compression. Prospective studies of anatomical and hemostatic changes after renal transplantation in recipients with polycystic kidney disease are warranted.
Tveit
D P
DP
Nephrology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Hypolite
I
I
Bucci
J
J
Hshieh
P
P
Cruess
D
D
Agodoa
L Y
LY
Welch
P G
PG
Abbott
K C
KC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology; D012042:Registries; D012307:Risk Factors; D012709:Serum Albumin; D014481:United States / Q000453:epidemiology
D012709:Serum Albumin