title: Differential Characteristics of Kidney Transplant Recipients According to 1-Year Chronic Kidney Disease Stage 3a and Stage 3b Graft Function.
abstract: The outcomes of transplantation have improved, but more than 50% of kidney transplantation (KT) recipients are still reported to have renal function of chronic kidney disease (CKD) stage 3 at 1 year after KT. We reviewed all 1235 patients who received a KT in our institution between 2008 and 2012. Among these recipients, 77 and 289 cases were included in the estimated glomerular filtration rate (eGFR) at 1 year after KT 30-44 (CKD stage 3b) group and eGFR 45-59 (CKD stage 3a) group, respectively. Longer duration of dialysis (odds ratio [OR] = 1.007, 95% confidence interval [CI], 1.000-1.014, P = 0.047), older donors (OR = 1.064, 95% CI, 1.031-1.098, P < 0.001), delayed graft function (OR = 3.601, 95% CI, 1.031-1.098, P < 0.001), BK virus infection (OR = 2.567, 95% CI, 1.242-5.305, P = 0.011), and pneumonia (OR = 4.451, 95% CI, 1.388-14.279, P = 0.012) were contributing factors to eGFR 30-44 mL/min. Especially, ureteral stricture occurred more frequently in eGFR 30-44 group of deceased donor KT. However, acute rejection was not a significant risk factor of lower eGFR. Graft survival was better in the eGFR 45-59 group. However, this difference was smaller in deceased donor KT. Infections and urologic complications are also important contributing factors of lower graft function in CKD stage 3. In addition, dividing CKD stage 3 into subgroups might be more useful in living donor kidney transplantation.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul.
authors.forename: Chung Hee
authors.initials: CH
authors.lastname: Baek
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul.
authors.forename: Hyosang
authors.initials: H
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul.
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Yang
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul.
authors.forename: Su-Kil
authors.initials: SK
authors.lastname: Park
mesh_terms: D000328:Adult; D064591:Allografts / Q000473:pathology; D001706:Biopsy; D051799:Delayed Graft Function / Q000453:epidemiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D066027:Transplant Recipients / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: -Chronic kidney disease; -Glomerular filtration rate; -Transplantation; Kidney