NUSA PURNAWAN PUTRA1, ZAIRULLAH MIGHFAZA1, AYUDYAH NURANI1, ARWEDI ARWANTO1, LESTARININGSIH LESTARININGSIH1, SHOFA CHASANI1, DWI LESTARI PARTININGRUM1
1Division of Nephrology and Hypertension, Departement of Internal Medicine, Medical Faculty, Universitas Diponegoro/Kariadi Hospital Semarang, Semarang, Indonesia
Aim: To determine risk factors for mortality within one year and three years after kidney transplant.
Background: Kidney transplantation is the most desired and cost-effective modality of renal replacement therapy for patients with end-stage kidney disease (ESKD). Identification of the risk factors for mortality may help clinicians improve transplant outcomes.
Methods: This study included 46 patients from 2014 to 2020 who underwent kidney transplantation. Their demographic data including age and gender (both donor and recipient), diabetes mellitus, left ventricular ejection fraction (LVEF), human leukocyte antigen (HLA)-matching, cross-match, type of immunosuppressant protocol, and warm ischemic time at baseline time, during the first year and three years after transplantation.
Results: The one year and three year mortality were 8 (17.4%) and 11 (23.9%), respectively. Bivariate analysis showed that recipient age more than 40 years (Relative risk (RR) 14.5; 95% confidence interval (CI), 1.95-107.16; P<0.001) and diabetes mellitus (RR 8.2; 95% CI, 2.93-22.94; P<0.001) were associated with higher one year mortality. It was also showed that recipient age more than 40 years (RR 3.61; 95% CI, 1.25-10.46; P=0.01) and diabetes mellitus (RR 4.68; 95% CI, 2.09-10.47; P=0.002) were associated with higher three year mortality. Multivariate analysis showed that diabetes mellitus (RR 36.14; 95% CI, 1.04-1247.48; P=0.04) was found the only risk factor for three year mortality but not for one year mortality. On the other hand, HLA-matching, type of immunosuppressant protocol, and ejection fraction had no association with mortality rate.
Conclusions: Older age more than 40 years, and diabetes mellitus are significant risk factors for one year and three year mortality after kidney transplantation.
Keywords: kidney transplantation; risk factors; one year mortality, three year mortality
Biography:
Born and raised in Jakarta, Nusa Putra was completed his education as a specialist in internal medicine at the Medical Faculty of Universitas Diponegoro in 2021. He is currently undergoing a trainee program at the Division of Nephrology and Hypertension, Medical Faculty of Universitas Diponegoro/Kariadi Hospital. He is also an active member of the Indonesian Doctors Association, the Indonesian Society of Internal Medicine, and the Indonesian Society of Nephrology.