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Long-term deterioration of kidney allograft function.
Bertram L Kasiske1, Robert S Gaston, Sita Gourishankar
1Department of Medicine, University of Minnesota, Minneapolis, USA. kasis001@umn.edu
Summary
Kidney transplant recipients show improved long-term allograft function over time. Recent transplant eras demonstrate a slower decline in estimated glomerular filtration rate (eGFR), enhancing patient survival.
Area of Science:
- Nephrology
- Transplantation immunology
- Medical statistics
Background:
- Long-term kidney allograft function is crucial for patient survival.
- Limited research exists on the longitudinal changes in renal allograft function post-transplantation.
Purpose of the Study:
- To analyze trends in renal allograft function decline over time.
- To evaluate the impact of transplantation era on long-term graft survival and function.
Main Methods:
- Pooled data analysis of 10,278 kidney transplants from five centers.
- Calculation of estimated glomerular filtration rate (eGFR) slopes at 1, 6, and 12 months post-transplant.
- Cox proportional hazards analysis to assess the risk of eGFR reduction.
Main Results:
- A significant improvement in the rate of eGFR decline was observed across successive transplantation eras (1984-2002).
- The most recent era (1999-2002) showed a significantly slower decline in eGFR slopes compared to earlier periods.
- Cox analysis indicated a reduced risk of a 25% eGFR reduction in the 1999-2002 era compared to 1984-1989.
Conclusions:
- The rate of decline in kidney allograft function has improved over recent decades.
- These findings suggest that stable, long-term allograft function is increasingly achievable.
- Improved graft function contributes to better long-term outcomes for kidney transplant recipients.