Admissions Within the First Year After Kidney Transplantation: Evaluation of Risk Factors, Causes, and Outcomes
Keywords:
Kidney Transplantation, Hospitalization, Opportunistic InfectionsAbstract
Objectives: The aim of this study was to evaluate causes of hospital admission within the 1st year after kidney transplantation in a public hospital. Methods: This is a retrospective cohort. Data were collected by medical record review. Inclusion criteria were age older than 18 years and kidney transplant. Exclusion criteria were double transplant, primary graft failure, and in-hospital death after transplant procedure. Outcomes included 4-year patient survival (primary outcome), 1-year graft failure, and graft function in 1 year. Results: A total of 130 patients were evaluated. There was a predominance of male sex, glomerulonephritis, history of hemodialysis, first kidney transplant, and deceased donor kidneys. Hospital admission in the 1st year occurred in 71.5%. There were three deaths at the first admission (two had cardiovascular causes). The most frequent causes of admission were infections, rejection, and surgical complications. Less common causes included elective procedures such as peritoneal dialysis catheter removal. There was no statistically significant association between categorical and continuous variables studied and the occurrence of hospital admission. Also, hospital admission did not influence primary outcome or 1-year graft failure rate. However, it was associated with lower graft function at 1 year (both by serum creatinine and by estimated glomerular filtration rate – p < 0.05). Conclusion: There was a high incidence of hospital admission, and first admissions resulted in death in three patients (noninfectious causes). Considering the contribution of elective procedures to the high incidence of admission, we propose that hospital managers focus on improving the ability to solve such problems in the outpatient setting.
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