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Experimental and Clinical Transplantation 2016-Oct

Are Kidney Transplant Patients Receiving Chronic Kidney Disease Treatment? A Comparative Study to Predialysis Patients in a Multidisciplinary Setting.

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Moisés Carminatti
Natália Maria Silva Fernandes
Fernando Antônio Basile Colugnati
Helady Sanders-Pinheiro

Mots clés

Abstrait

OBJECTIVE

Kidney transplant recipients present with treatable complications related to chronic kidney disease, similarly to predialysis patients. The role of multidisciplinary clinics in the management of these complications in kidney transplant recipients is not fully understood. The objective of the present study was to compare the availability of specific treatments for chronic kidney disease-related complications between predialysis patients and kidney transplant recipients, both followed by a multidisciplinary team.

METHODS

In a cross-sectional study, we compared the prevalence of chronic kidney disease-related complications and the presence or absence of treatment for those complications, when clinically indicated, in 133 kidney transplant recipients and 114 predialysis patients, all followed by a multidisciplinary team of nephrologists, nurses, dieticians, social workers, and psychologists.

RESULTS

Kidney transplant recipients were younger, had better kidney function, and lower prevalence of hypertension, proteinuria, diabetes, obesity, cardiovascular disease, anemia, hyperuricemia, hypocalcemia, and hyperphosphatemia. However, the availability of treatment for anemia (odds ratio of 0.58; 95% confidence interval, 0.2-1.6; P = .31), dyslipidemia (odds ratio of 0.9; 95% confidence interval, 0.3-2.4; P = .84), metabolic acidosis (odds ratio of 3.75; 95% confidence interval, 0.8-18.2; P = .101), hyperphosphatemia (odds ratio of 1.89; 95% confidence interval, 0.3-10.8; P = .47), and hyperuricemia (odds ratio of 1.3; 95% confidence interval, 0.3-6.2; P = .73) was similar between the groups.

CONCLUSIONS

Despite clinical and demographic differences, the comparable treatment directed to chronic kidney disease-related complications for both predialysis patients and kidney transplant recipients suggests that a multidisciplinary approach could be appropriate for better clinical management of chronic kidney disease in kidney transplant recipients.

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