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10.1097/TXD.0000000000000606

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suck abstract from ncbi


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pmid27819037
      Transplant+Direct 2016 ; 2 (8 ): e96
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  • Classification of Kidney Transplant Recipients Using a Combination of Estimated GFR and Albuminuria Reflects Risk #MMPMID27819037
  • White CA ; Akbari A ; Talreja H ; Lalani N ; Knoll GA
  • Transplant Direct 2016[Aug]; 2 (8 ): e96 PMID27819037 show ga
  • BACKGROUND: The 2012 Kidney Dialysis Initiative Global Outcomes chronic kidney disease (CKD) classification scheme subdivides stage 3 CKD and incorporates the urinary albumin-to-creatinine ratio (ACR). The aim of this study was to evaluate whether the novel scheme provides graded risk in kidney transplant recipients (KTRs). METHODS: Prevalent KTRs with available laboratory data were included. The primary outcome was a composite of doubling of serum creatinine, graft failure, or death. Patients were stratified using the CKD-Epidemiolgic Collaboration equation, and ACR and the event rate per 1000 patient-years in each CKD category were calculated. RESULTS: There were 269 KTRs with a mean follow-up of 4.5 ± 2.0 years. There was a graded increase in outcomes with increasing ACR and decreasing estimated glomerular filtration rate (eGFR). For the primary outcome, the event rate was 15.3 (95% confidence interval, 4.2-39.2) per 1000 patient-years for those with an eGFR greater than 60 mL/min per 1.73 m(2) and an ACR less than 30 mg/g, whereas it was 375 (95% confidence interval, 193.8-655.1) for those with an eGFR less than 30 mL/min per 1.73 m(2) and an ACR greater than 300 mg/g. CONCLUSIONS: The novel Kidney Dialysis Initiative Global Outcomes classification scheme provides graded risk for important clinical events in KTRs. This information can be used to identify high-risk patients and to tailor follow-up and management strategies aimed at improving outcomes.
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