Mortality on a renal transplantation waiting list

Area of Science:

• Nephrology
• Transplantation Medicine
• Public Health

Background:

• Advanced chronic kidney disease (ACKD) necessitates renal transplantation (Tx) as the primary treatment.
• A critical shortage of donor organs exacerbates mortality risks for Tx-eligible patients, particularly those with significant comorbidities like diabetes and hypertension.
• Rising ACKD prevalence and waiting list numbers heighten concerns about patient survival.

Purpose of the Study:

• To review mortality causes and risk factors in patients awaiting kidney transplantation.
• To identify barriers limiting access to Tx and contributing to increased mortality.
• To evaluate the risk of death from comorbidity in dialysis patients and assess mortality on the waiting list.

Main Methods:

• Review of epidemiological data on ACKD and Tx waiting lists.
• Analysis of mortality risk factors and access barriers to kidney transplantation.
• Evaluation of comorbidity-related mortality in dialysis patients.
• Application of competitive risk regression analysis and development of a compound risk model for mortality prediction.

Main Results:

• High mortality rates observed in patients on the kidney transplant waiting list, influenced by organ scarcity and comorbidities.
• Comorbidities, such as diabetes and hypertension, significantly increase mortality risk in ACKD patients.
• Barriers to Tx access contribute to prolonged waiting times and elevated mortality.

Conclusions:

• Urgent need to address organ shortages and optimize Tx access for ACKD patients.
• Developing predictive mortality models incorporating comorbidity and uremic factors is essential for improving patient survival.
• Interventions targeting risk factors and reducing Tx barriers are critical for managing ACKD patient outcomes.