High Mortality and Associated Risk Factors in Kidney Transplant Recipients With Cryptococcosis-A Nationwide Cohort...

Area of Science:

• Nephrology
• Infectious Diseases
• Transplantation Immunology

Background:

• Cryptococcosis is a severe invasive fungal infection impacting kidney transplant recipients (KTRs).
• Existing prognostic factor research for KTR mortality is limited by small-scale, single-center studies.

Purpose of the Study:

• To investigate the hospitalization rates and outcomes of cryptococcosis in US KTRs.
• To identify key mortality predictors in KTRs diagnosed with cryptococcosis.

Main Methods:

• A retrospective cohort study utilized data from the US Renal Data System (2006-2016).
• Demographics, comorbidities, transplant complications, and mortality data were analyzed.
• Multivariable logistic regression identified factors associated with 6-month mortality.

Main Results:

• 1265 KTRs were hospitalized for cryptococcosis, with a 6-month mortality rate of 22%.
• Significant mortality predictors included cirrhosis, ICU admission, pre-transplant dialysis, lack of tacrolimus, older age, AKI, and post-transplant complications.
• Cirrhosis presented the highest adjusted odds ratio for mortality (aOR, 3.1).

Conclusions:

• Early mortality following cryptococcosis hospitalization remains a critical concern for KTRs.
• Cirrhosis is identified as the most potent independent risk factor for mortality in this population.
• These findings underscore the need for enhanced monitoring and management strategies for KTRs with cryptococcosis, especially those with cirrhosis.