Long-Term Kidney Transplant Outcomes Linked to 30% eGFR Decline
An eGFR decline of at least 30% during the 6 to 24 months after kidney transplantation predicts a higher risk of graft loss.
A 30% or greater decline in estimated glomerular filtration rate (eGFR) during 6 to 24 months after kidney transplantation is a surrogate for long-term transplant outcomes, according to findings presented at the 2016 American Transplant Congress in Boston.
In an observational, prospective study, Geovani Faddoul, MD, of the Icahn School of Medicine at Mount Sinai in New York, and colleagues analyzed 5-year outcome data from 183 kidney transplant recipients with a mean age of 42 years. Overall, 2-year eGFR and a 30% or greater decline in eGFR over 6 to 24 months post-transplant, but not early immune marker status, each was associated with lower 5-year eGFR, Dr. Faddoul's group reported.
In multivariable analysis, a 30% or greater decrease in eGFR over 6 to 24 months post-transplant was associated with a 21.3 mL/min/1.73 m2 lower 5-year eGFR compared with those who had a smaller decrease in eGFR, after adjusting for peak PRA and donor age. The 30% or greater decrease also was associated with a greater likelihood of chronic kidney disease stage IIIb (66.6% vs. 24.5%). The proportion of patients who experienced graft loss was significantly larger in the group with a 30% or greater decline in eGFR (31% vs. 4%).
The investigators concluded that their findings support the use of a 30% or greater decline in eGFR over the initial 2 years post-transplant as a surrogate for long-term kidney transplant outcomes.