Decreasing Estimated Glomerular Filtration Rate Is Associated With Increased Risk of Hospitalization After Kidney Transplantation

• Type of Material: Article
• Authors: Farrah M. Keong, Emory University; Yama A. Afshar, Emory University; Stephen Pastan, Emory University; Ritam Chowdhury, Emory University; Jose N. Binongo, Emory University; Rachel Patzer, Emory University
• Language: English
• Date: 2016-01-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2016 International Society of Nephrology
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ekir.2016.08.008
• Title of Journal or Parent Work: Kidney International Reports
• ISSN: 2468-0249
• Volume: 1
• Issue: 4
• Start Page: 269
• End Page: 278
• Grant/Funding Information: REP and SOP are both supported in part by R24MD008077 and RMD010290A through the National Institute on Minority Health and Health Disparities.; This work was partially funded from Emory University's Open Access Publishing Fund.
• Keywords: estimated glomerular filtration rate; kidney transplant; hospital readmission
• Research Categories: Health Sciences, Epidemiology; Health Sciences, General

Abstract

Introduction After renal transplantation, decreased renal function is associated with increased risk of cardiovascular disease, graft loss, and mortality. We investigated whether declining renal function was associated with hospitalization after transplantation. Methods Adult, first-time, kidney transplant recipients between 2004 and 2006 from the United Network for Organ Sharing database and hospitalizations 1 year after the 6-month posttransplant follow-up visit were examined. Generalized linear models explored the relationship between estimated glomerular filtration rate (eGFR) measured at 6 months and the number of hospitalizations in the following year. Results Of 15,778 kidney transplant recipients, 19.1% were admitted in the year after the 6-month follow-up visit. Among those hospitalized, the mean number of hospitalizations was 1.71, which increased with decreasing eGFR. In multivariable models, a decrease in eGFR was significantly associated with increased hospitalizations: for every 10 ml/min per 1.73 m2 decrease in eGFR, there was an 11% increase in hospitalization rate (P < 0.001). Lower eGFR after the first 6 months after transplantation was associated with an increase in late hospitalizations among adult kidney transplant recipients. Discussion Identifying patients with declining eGFR and other risk factors may help prevent morbidity and mortality associated with hospitalization after transplantation.