Introduction:
Kidney transplantation is considered a gold-standard treatment for patients with end-stage renal disease. It has been reported, that on the waiting list for kidney transplantation coronary artery disease was the most common comorbidity and diabetes mellitus was the leading cause of ESRD in some countries. In general, in Europe as well as in other parts of the world there are scarce published data on potential kidney allograft recipients in this regard. The aim of this study was to assess the prevalence, characteristics, and determinants of different risk factors in an unselected large population of patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) throughout the country.
Methods:
From the population of 5886 hemodialyzed patients (60% of men), obtained from one of the biggest providers of hemodialysis in the country we extracted 449 waitlisted hemodialyzed patients and 4619 patients not considered for potential kidney transplantation. The remaining 820 patients were excluded due to either temporary disqualification or being in the process of evaluation and were not considered for analysis. Finally, a database of 5068 patients (mean age 66 ± 14.0 years, 66% of males receiving hemodialysis) was analyzed. We assessed demographic data, basal biochemical data, cardiovascular disease prevalence, dialysis vintage. Patients were divided in two groups: active and non-active on kidney transplantation list.
Results:
The analyzed data shows that the active group is ten times smaller [449 (8.85%)]. Waitlisted patients (262 males) were significantly younger when compared to non-listed patients (2718 males) (53,2±14.2 vs 67,2 ± 13.3 years, p<0,001), had lower Charslon comorbidity score (3,33 ± 1.52 vs 4,42 ± 1.93, p<0,001), lower BMI (26.3±.5.07 kg.m2 vs 27.7 ± 6.15 kg.m2, p<.001), with lower prevalence of cardiovascular disease (46.5% vs 66.8%, p<0.001) and diabetes (20.5% vs 37,8%, p<0.001). Blood pressure was significantly higher in waitlisted patients relative to non-listed (143 ± 16 mmHg vs 140 ± 17 mmHg, p<0.001 for systolic blood pressure and 80 ±9 mmHg vs 75 ± 9 mmHg, p<0.001 for diastolic blood pressure). Ultrafiltration was also higher in waitlisted population over non-listed (2288 ± 907 ml/per HD session vs 2075 ± 892 ml/per HD session, p<0.001). Mean dialysis vintage, mean number of hypotensive medications (mean 2.5), eKt/v were similar, as well as gender distribution.
Conclusions:
In the real-life world, during qualification to kidney transplant we look up different risk factors that may make an impact on the evaluation. We can see through this study that higher age, higher BMI, cardiovascular disease and diabetes have the major impact on the qualification and finally waitlisting.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.