ESPN 51th Annual Meeting

ESPN 2018


 
The impact of primary renal disease on long-term graft survival in kidney transplant recipients
SERMIN OZCAN 1 NUR CANPOLAT 1 SEHA KAMIL SAYGILI 1 MEHMET ELICEVIK 2 ERKAN YILMAZ 3 SALIM CALISKAN 1 LALE SEVER 1

1- ISTANBUL UNIVERSITY CERRAHPASA FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- ISTANBUL UNIVERSITY CERRAHPASA FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC SURGERY
3- ISTANBUL UNIVERSITY CERRAHPASA FACULTY OF MEDICINE, BLOOD BANK TISSUE TYPING LABORATORY
 
Introduction:

There are controversial reports on the effect of primary renal disease on graft survival after kidney transplantation (KTx). The aim of the present study was to determine long-term renal function in patients with CAKUT and to compare those in patients with non-CAKUT etiology.

Material and methods:

This retrospective single-center study included 67 KTx recipients (33 CAKUT, 34 non-CAKUT) transplanted under the age of 18 years and regularly followed-up at least one year after transplantation. Patients with early (<3 months post-transplant) graft loss were not included in the study. Estimated glomerular filtration rate (eGFR) was calculated using the modified Schwartz equation for patients <18 years of age and the MDRD equation for patients ≥18 years of age for the baseline (10th week) and follow-up. 

Results:

There was no difference between the CAKUT and non-CAKUT patients considering demographic characteristics or transplantation features (percentage of preemptive KTx or living donors, donor age, HLA mismatch, cold ischemia time), except the time on the waiting list which was longer in CAKUT patients (p=0.003). The median (25th;75th p) eGFR at the 10th week and at the 1st year of transplantation were significantly lower in CAKUT patients compared to those in non-CAKUT patients [76 (61;92) vs 93 (77;121) mL/min/1.73m2, p=0.004 and 73 (60;94) vs 94 (62;119) mL/min/1.73m2, p=0.048); however, the difference did not persist at the follow-up. At the 5th year of transplantation, there was a median 16% decline in eGFR in CAKUT patients, while this decrease was 6% in non-CAKUT patients (p=0.89). Decline in eGFR at the 5th year of transplantation was significantly associated with an increase in the number of urinary tract infection (UTI) during the first year of transplantation in CAKUT patients (p=0.008), but not in non-CAKUT patients.  

Conclusions:

UTI may play a role in worse graft function in patients with CAKUT etiology.