First-year renal function predicts long-term renal allograft loss.

Area of Science:

• Nephrology
• Transplantation Medicine
• Clinical Chemistry

Background:

• Long-term kidney graft survival is crucial for patients with end-stage renal disease.
• Predicting graft failure early can optimize patient care and resource allocation.

Purpose of the Study:

• To evaluate the impact of first-year post-transplant renal function, assessed by serum creatinine, on long-term graft survival.
• To determine if early serum creatinine levels can serve as surrogate endpoints for graft loss.

Main Methods:

• Retrospective analysis of 1,273 adult kidney transplants (1983-2008).
• Cox proportional hazards multivariable analysis to assess the relationship between first-year serum creatinine and death-censored graft loss.
• Included serum creatinine at 1, 6, and 12 months post-transplant.

Main Results:

• First-month serum creatinine and the change between 1 and 6 months independently predicted long-term graft loss.
• Predictive value of creatinine persisted at 6 and 12 months.
• Other predictors included donor age, acute rejection, recipient age, and female gender.

Conclusions:

• Post-transplant serum creatinine levels at 1, 6, and 12 months are independent predictors of kidney graft survival.
• These creatinine levels may serve as valuable surrogate endpoints for long-term death-censored graft loss.