Risk factors for rising creatinine in renal allografts with 1 and 3 yr survival

Steven Paraskevas, Raja Kandaswamy, Abhinav Humar, Kristen J. Gillingham, Rainer W G Gruessner, William D. Payne, John S. Najarian, David E R Sutherland, Arthur J. Matas

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Determining factors associated with negative slope of inverse creatinine vs. time (1/Cr vs. t) may help prevent a decline in renal allograft function. Methods: A total of 1389 adult recipients of primary renal transplants were divided into quartiles based on the slope of 1/Cr vs. t calculated from 6 and 12 months post transplant. A multivariate analysis of risk factors for being in the worst vs. best quartile employed these variables: donor source, HLA mismatch, recipient age, donor age, panel-reactive antibody (PRA), acute rejection (AR), 3-month cyclosporin A (CsA) level, 1-yr CsA level and acute tubular necrosis. Two separate analyses compared risk factors in patients with 1 and 3 yr survival, respectively. Results: In recipients with ≥1 yr graft survival, highPRA and AR were associated with negative slopes of 1/Cr vs. t. For those with ≥3 yr graft survival, both AR and 3-month CsA level >150 ng/mL were significant risk factors, using both 6- and 12-month slopes. Stratification of AR showed 1 AR episode ≥6 months and multiple AR episodes carried significant risk for negative slopes. Conclusion: Optimization of allograft function invokes a conundrum between the needs to avoid both AR and high early CsA levels. We support a policy of carefully balancing these two risks.

Original languageEnglish (US)
Pages (from-to)667-672
Number of pages6
JournalClinical Transplantation
Volume20
Issue number6
DOIs
StatePublished - Nov 2006
Externally publishedYes

Fingerprint

Cyclosporine
Allografts
Creatinine
Kidney
Survival
Graft Survival
Tissue Donors
Transplants
Necrosis
Multivariate Analysis
Antibodies

Keywords

  • Calcineurin inhibitors
  • Creatinine
  • Kidney
  • Outcomes
  • Slope

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Paraskevas, S., Kandaswamy, R., Humar, A., Gillingham, K. J., Gruessner, R. W. G., Payne, W. D., ... Matas, A. J. (2006). Risk factors for rising creatinine in renal allografts with 1 and 3 yr survival. Clinical Transplantation, 20(6), 667-672. https://doi.org/10.1111/j.1399-0012.2006.00566.x

Risk factors for rising creatinine in renal allografts with 1 and 3 yr survival. / Paraskevas, Steven; Kandaswamy, Raja; Humar, Abhinav; Gillingham, Kristen J.; Gruessner, Rainer W G; Payne, William D.; Najarian, John S.; Sutherland, David E R; Matas, Arthur J.

In: Clinical Transplantation, Vol. 20, No. 6, 11.2006, p. 667-672.

Research output: Contribution to journalArticle

Paraskevas, S, Kandaswamy, R, Humar, A, Gillingham, KJ, Gruessner, RWG, Payne, WD, Najarian, JS, Sutherland, DER & Matas, AJ 2006, 'Risk factors for rising creatinine in renal allografts with 1 and 3 yr survival', Clinical Transplantation, vol. 20, no. 6, pp. 667-672. https://doi.org/10.1111/j.1399-0012.2006.00566.x
Paraskevas, Steven ; Kandaswamy, Raja ; Humar, Abhinav ; Gillingham, Kristen J. ; Gruessner, Rainer W G ; Payne, William D. ; Najarian, John S. ; Sutherland, David E R ; Matas, Arthur J. / Risk factors for rising creatinine in renal allografts with 1 and 3 yr survival. In: Clinical Transplantation. 2006 ; Vol. 20, No. 6. pp. 667-672.
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