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Paediatric renal transplantation non-compliance
K E Meyers1, H Weiland, P D Thomson
1Division of Paediatric Nephrology, University of the Witwatersrand Medical School, South Africa.
Pediatric Nephrology (Berlin, Germany)
|April 1, 1995
Summary
Pediatric renal transplant non-compliance (NC) was found in 22% of patients, particularly in peripubertal individuals and lower social classes. Lower cyclosporine A (CsA) levels were significantly associated with non-compliance.
Area of Science:
- Pediatric Nephrology
- Transplant Medicine
- Clinical Pharmacy
Background:
- Non-compliance (NC) is a significant challenge in pediatric renal transplantation, impacting graft survival.
- Quantifying NC and identifying associated risk factors is crucial for improving patient outcomes.
Purpose of the Study:
- To quantify the magnitude of non-compliance in pediatric renal transplant recipients.
- To identify factors associated with non-compliance, including demographic, social, and clinical variables.
Main Methods:
- Retrospective analysis of 77 pediatric renal transplant cases between 1984 and 1989.
- NC assessed via missed clinic visits, medication shortages, or admissions.
- Cyclosporine A (CsA) trough levels used to objectively confirm compliance.
Main Results:
- Non-compliance (NC) was observed in 22% of patients.
- NC showed a positive correlation with lower social classes (III and IV).
- Patients with NC were 8 times more likely to have low CsA trough levels (< 10 ng/ml).
Conclusions:
- Non-compliance is a significant issue in pediatric renal transplantation.
- Lower socioeconomic status is a key risk factor for NC.
- Low CsA trough levels serve as an objective indicator of non-compliance.