Are Kidney Transplant Patients Receiving Chronic Kidney Disease Treatment? A Comparative Study to Predialysis Patients in a Multidisciplinary Setting.
OBJECTIVE
Kidney transplant recipients present with treatable complications related to chronic kidney disease, similarly to predialysis patients. The role of multidisciplinary clinics in the management of these complications in kidney transplant recipients is not fully understood. The objective of the present study was to compare the availability of specific treatments for chronic kidney disease-related complications between predialysis patients and kidney transplant recipients, both followed by a multidisciplinary team.


METHODS
In a cross-sectional study, we compared the prevalence of chronic kidney disease-related complications and the presence or absence of treatment for those complications, when clinically indicated, in 133 kidney transplant recipients and 114 predialysis patients, all followed by a multidisciplinary team of nephrologists, nurses, dieticians, social workers, and psychologists.


RESULTS
Kidney transplant recipients were younger, had better kidney function, and lower prevalence of hypertension, proteinuria, diabetes, obesity, cardiovascular disease, anemia, hyperuricemia, hypocalcemia, and hyperphosphatemia. However, the availability of treatment for anemia (odds ratio of 0.58; 95% confidence interval, 0.2-1.6; P = .31), dyslipidemia (odds ratio of 0.9; 95% confidence interval, 0.3-2.4; P = .84), metabolic acidosis (odds ratio of 3.75; 95% confidence interval, 0.8-18.2; P = .101), hyperphosphatemia (odds ratio of 1.89; 95% confidence interval, 0.3-10.8; P = .47), and hyperuricemia (odds ratio of 1.3; 95% confidence interval, 0.3-6.2; P = .73) was similar between the groups.


CONCLUSIONS
Despite clinical and demographic differences, the comparable treatment directed to chronic kidney disease-related complications for both predialysis patients and kidney transplant recipients suggests that a multidisciplinary approach could be appropriate for better clinical management of chronic kidney disease in kidney transplant recipients.
From the Renal Transplant Unit, Division of Nephrology, Federal University of Juiz de Fora Hospital, and the Interdisciplinary Center for Studies and Research in Nephrology (NIEPEN), Juiz de Fora, Minas Gerais, Brazil.
Moisés
M
Carminatti
Natália Maria Silva
NM
Fernandes
Fernando Antônio Basile
FA
Colugnati
Helady
H
Sanders-Pinheiro
D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000639:trends*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010348:Patient Care Team / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D019984:Quality Indicators, Health Care / Q000639:trends; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome