Noncompliance with immunnosuppressive medications after renal transplantation

Noncompliance with immunosuppressive medications in renal transplant recipients results in higher rate of acute rejection episodes, allograft dysfunction, graft loss and patient death. We studied incidence and risk factors of medications noncompliance in 286 renal transplant recipients who were consecutively seen in our renal transplant clinic between February and April 2002. One hundred and seventy were male, 116 female. Their age ranged from 12 to 70 years (mean 39.1+/-11.6). The length of time since the date of transplantation ranged from 5 to 231 months (mean 76.7+/-53.5). The results of study showed that 70 patients (24.5%) to be noncompliant (7.7% noncompliant minor and 16.8% noncompliant major). The time since the date of transplanation was a significant risk factor in both noncompliant minor and major groups (P<0.001 and P<0.001). The other risk factors associated with major noncompliance was young age (P<0.001), lower level of education (P<0.01), lower socioeconomic class (P<0.05), addiction and psychiatric disorders (P<0.05). Transplant recipients with major noncompliance also had more acute rejection episodes (P<0.001) and allograft dysfunction (P<0.01). We conclude that noncompliance with immunosuppressive medications is very common in renal transplant recipients and it results to significant acute rejection episodes and allograft failure.