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Association of admission, nadir, and terminal donor creatinine with kidney transplantation outcomes

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dc.contributor.authorIrish, G.L.
dc.contributor.authorCoates, P.T.
dc.contributor.authorClayton, P.A.
dc.date.issued2021
dc.description.abstractIntroduction: When assessing deceased kidney donors, a key factor in organ acceptance and allocation is donor kidney function. It is unclear whether terminal, admission, or the highest of terminal and admission donor estimated glomerular filtration rate (eGFR) most predicts recipient outcomes. Methods: We examined which measurement best predicts outcomes. Using data from the Australia and New Zealand Organ Donation and Dialysis and Transplant Registries, we included adult recipients of deceased donor kidney-only transplants over 2003 to 2019. We compared the 3 different exposure vari ables of admission, terminal, or highest eGFR. We created logistic regression models for delayed graft function (DGF), multilinear regression models for 6- and 12-month eGFR, and Cox proportional hazards models for graft loss, death censored graft failure and patient death. Results: A total of 8971 transplant recipients were included. There was strong evidence of an association between terminal, admission, and highest donor eGFR and DGF and recipient eGFR at 6 and 12 months. The eGFR was a strong predictor of graft and death censored graft failure, but not patient death. Terminal was a better predictor than admission and highest eGFR particularly for more contemporaneous outcomes. Conclusion: In assessing kidney donors, terminal eGFR were marginally better than admission and highest at predicting outcomes. Terminal eGFR should be used in risk equations to predict hard clinical endpoints.
dc.description.statementofresponsibilityGeorgina L. Irish, P. Toby Coates and Philip A. Clayton
dc.identifier.citationKidney International Reports, 2021; 6(8):2075-2083
dc.identifier.doi10.1016/j.ekir.2021.05.005
dc.identifier.issn2468-0249
dc.identifier.issn2468-0249
dc.identifier.orcidIrish, G.L. [0000-0003-0758-1867]
dc.identifier.orcidClayton, P.A. [0000-0001-9190-6753]
dc.identifier.urihttps://hdl.handle.net/2440/132476
dc.language.isoen
dc.publisherElsevier
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1092957
dc.rights© 2021 International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.source.urihttps://doi.org/10.1016/j.ekir.2021.05.005
dc.subjectdelayed graft function; epidemiology; graft function; graft survival; survival analysi
dc.titleAssociation of admission, nadir, and terminal donor creatinine with kidney transplantation outcomes
dc.typeJournal article
pubs.publication-statusPublished

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