Recipient-related predictors of kidney transplantation outcomes in the elderly

Parta Hatamizadeh, Miklos Z. Molnar, Elani Streja, Paungpaga Lertdumrongluk, Mahesh Krishnan, Csaba Kovesdy, Kamyar Kalantar-Zadeh

Research output: Contribution to journalArticle

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Abstract

Background: It is not clear whether in old people with end-stage renal disease kidney transplantation is superior to dialysis therapy. Methods: We compared mortality rates between kidney transplant recipients (KTRs) and the general population across different age categories. We also examined patient and allograft survival in 15 667 elderly KTRs (65-<90 yr old, 36% female) within three age subgroups (65-<70, 70-<75, and ≥75 yr). Results: The rise in the relative risk of death in older age groups was substantially less in KTRs than in the general population, that is, 1.8 and 2.0 vs. 21.4 and 76.6 in those aged 65-<75 and ≥75 yr, respectively, compared with 15- to <65-yr-old people (reference group). In 65- to <70-yr-old KTRs, obesity (BMI>30 kg/m2) was associated with 19% higher risk of graft failure (HR: 1.19 [1.07-1.33], p = 0.002). Diabetes was a predictor of worse patient survival in all age groups but poorer allograft outcome in the youngest age group (65-<70 yr old) only. None of the examined risk factors affected allograft outcome in the oldest group (≥75 yr old) although there was a 49% lower trend of graft failure in very old Hispanic recipients (HR: 0.51 [0.26-1.01], p = 0.05). Conclusions: Kidney transplantation may attenuate the age-associated increase in mortality, and its superior survival gain is most prominent in the oldest recipients (≥75 yr old). The potential protective effect of kidney transplantation on longevity in the elderly deserves further investigation.

Original languageEnglish (US)
Pages (from-to)436-443
Number of pages8
JournalClinical Transplantation
Volume27
Issue number3
DOIs
StatePublished - May 1 2013

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Kidney Transplantation
Allografts
Age Groups
Transplants
Kidney
Survival
Mortality
Hispanic Americans
Chronic Kidney Failure
Dialysis
Population
Transplant Recipients
Therapeutics

All Science Journal Classification (ASJC) codes

  • Transplantation
  • Medicine(all)

Cite this

Hatamizadeh, P., Molnar, M. Z., Streja, E., Lertdumrongluk, P., Krishnan, M., Kovesdy, C., & Kalantar-Zadeh, K. (2013). Recipient-related predictors of kidney transplantation outcomes in the elderly. Clinical Transplantation, 27(3), 436-443. https://doi.org/10.1111/ctr.12106

Recipient-related predictors of kidney transplantation outcomes in the elderly. / Hatamizadeh, Parta; Molnar, Miklos Z.; Streja, Elani; Lertdumrongluk, Paungpaga; Krishnan, Mahesh; Kovesdy, Csaba; Kalantar-Zadeh, Kamyar.

In: Clinical Transplantation, Vol. 27, No. 3, 01.05.2013, p. 436-443.

Research output: Contribution to journalArticle

Hatamizadeh, P, Molnar, MZ, Streja, E, Lertdumrongluk, P, Krishnan, M, Kovesdy, C & Kalantar-Zadeh, K 2013, 'Recipient-related predictors of kidney transplantation outcomes in the elderly', Clinical Transplantation, vol. 27, no. 3, pp. 436-443. https://doi.org/10.1111/ctr.12106
Hatamizadeh P, Molnar MZ, Streja E, Lertdumrongluk P, Krishnan M, Kovesdy C et al. Recipient-related predictors of kidney transplantation outcomes in the elderly. Clinical Transplantation. 2013 May 1;27(3):436-443. https://doi.org/10.1111/ctr.12106
Hatamizadeh, Parta ; Molnar, Miklos Z. ; Streja, Elani ; Lertdumrongluk, Paungpaga ; Krishnan, Mahesh ; Kovesdy, Csaba ; Kalantar-Zadeh, Kamyar. / Recipient-related predictors of kidney transplantation outcomes in the elderly. In: Clinical Transplantation. 2013 ; Vol. 27, No. 3. pp. 436-443.
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abstract = "Background: It is not clear whether in old people with end-stage renal disease kidney transplantation is superior to dialysis therapy. Methods: We compared mortality rates between kidney transplant recipients (KTRs) and the general population across different age categories. We also examined patient and allograft survival in 15 667 elderly KTRs (65-<90 yr old, 36{\%} female) within three age subgroups (65-<70, 70-<75, and ≥75 yr). Results: The rise in the relative risk of death in older age groups was substantially less in KTRs than in the general population, that is, 1.8 and 2.0 vs. 21.4 and 76.6 in those aged 65-<75 and ≥75 yr, respectively, compared with 15- to <65-yr-old people (reference group). In 65- to <70-yr-old KTRs, obesity (BMI>30 kg/m2) was associated with 19{\%} higher risk of graft failure (HR: 1.19 [1.07-1.33], p = 0.002). Diabetes was a predictor of worse patient survival in all age groups but poorer allograft outcome in the youngest age group (65-<70 yr old) only. None of the examined risk factors affected allograft outcome in the oldest group (≥75 yr old) although there was a 49{\%} lower trend of graft failure in very old Hispanic recipients (HR: 0.51 [0.26-1.01], p = 0.05). Conclusions: Kidney transplantation may attenuate the age-associated increase in mortality, and its superior survival gain is most prominent in the oldest recipients (≥75 yr old). The potential protective effect of kidney transplantation on longevity in the elderly deserves further investigation.",
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