Costs and factors associated with heart failure following kidney transplantation – a single‐center retrospective cohort study

Summary The number of adults with heart failure (HF) will increase by ~50% between 2012 and 2030. Among kidney transplant recipients, HF accounts for 16% of all post‐transplant admissions. We describe the burden of HF and predictors of healthcare utilization following kidney transplantation. We retrospectively identified adults who underwent kidney transplantation at our institution (01/2007–12/2017). Data were acquired from electronic health records, with healthcare utilization obtained from a statewide database. The HF incidence rate and prevalence were estimated for each year, total charges for HF and non‐HF patients were compared, and logistic regression was employed for a 3‐year predictive model of healthcare utilization associated with HF. Among 1731 kidney transplant recipients, the post‐transplant HF incidence rate ranged from 1.91 (year 3) to 6.80 (year 10) per 100 person‐years, while the prevalence increased from 31.7% (year 1) to 48.1% (year 10). Median charges were $75 837 (HF) compared to $42 940 (non‐HF) per person‐year ( P  < 0.001). Pretransplant HF [odds ratio (OR) = 3.12] and an eGFR < 45 (OR = 4.73) were the strongest predictors of HF encounters ( P  < 0.05 for both). We observed a high and increasing prevalence of HF, which was associated with twice the costs. Kidney transplant recipients would benefit from interventions aimed at mitigating HF risk factors.