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Impact of diabetes and chronic dialysis on post‐transplant survival in combined heart‐kidney transplant recipients
Author(s) -
Parekh Justin R.,
Lam Jenny,
Chau Harrison,
Berumen Jennifer,
Schnickel Gabriel T.,
Mekeel Kristin
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14338
Subject(s) - medicine , dialysis , diabetes mellitus , kidney disease , hazard ratio , transplantation , population , proportional hazards model , kidney transplantation , heart transplantation , nephrology , heart failure , intensive care medicine , confidence interval , endocrinology , environmental health
Growing research supports an increased survival benefit of combined heart and kidney transplantation in patients with both heart and renal failure. As a result, the frequency of these combined transplants continues to increase. Despite this trend, little has been done to quantify the impact of chronic illness in this population. We identified adult recipients of combined heart‐kidney transplant from the Scientific Registry of Transplant Recipients (SRTR) database between 2005 and 2018. We focused on renal disease secondary to diabetes and duration of dialysis as markers of chronic illness. The primary outcome was post‐transplant mortality. Our final multivariable Cox proportional hazard model found that diabetes‐associated renal disease (HR 1.57, 95% CI 1.14–2.15, p = .01) and dialysis duration (HR 1.08, 95% CI 1.01–1.15, p = .02) were significant predictors of post‐transplant mortality. Given the significant impact of dialysis duration and renal disease secondary to diabetes mellitus, these chronically ill patients should be closely examined for conditions such as peripheral vascular disease and frailty, which have been shown to affect mortality in heart transplant recipients and are prevalent in the chronic dialysis population.