Volume Overload Kidney Transplant Recipients Require More Treatments than Those with Hyperkalemia

Austin, Texas—In up to 60% of kidney transplantations with deceased donors and 8% with living donors, delayed graft function or dialysis occurs within 7 days following the procedure. Jacentha Buggs, MD, and colleagues conducted a retrospective cohort study to test the hypothesis that that is a difference in resource utilization based on the indication for dialysis in delayed graft function.

The study used data on consecutive kidney transplant recipients with delayed graft function at a single transplant center from January 2012 through December 2016. Patients were grouped by hyperkalemia or volume overload. The analysis was performed with t test (continuous), chi-squared test (binary), and Cox regression for time to event. Results were reported during a poster session at the NKF 2018 Spring Clinical Meetings in a poster titled Resource Utilization in Delayed Graft Function Based on the Indication for Dialysis in Kidney Transplantation.

During the study period, the transplant center performed 1131 kidney transplants; 902 involved a deceased donor and 229 involved a living donor. Of the 1132 procedures, 12.9% had delayed graft function (n=146; 72 with hyperkalemia and 74 with volume overload).

There was no statistical difference between the two groups based on age, kidney donor profile index, or calculated panel reactive antibody value. Length of stay (days) was longer for patients with volume overload compared with hyperkalemia (15 days vs 10 days; P<.001). Patients with volume overload required three treatments, compared with two treatments for patients with hyperkalemia (P=.007). There were no statistical differences between the two groups in patient survival or graft survival.

In conclusion, the researchers said, “Patients with delayed graft function dialyzed for volume overload required more transplant admission dialysis treatments and had longer hospital stays than patients dialyzed for hyperkalemia. Further multicenter collaborations are essential to further investigate resource utilization for different indications of delayed graft function.”

Source: Buggs J, Boone J, Adesunkanmi M, et al. Resource utilization in delayed graft function based on the indication for dialysis in kidney transplantation. Abstract of a poster presented at the National Kidney Foundation 2018 Spring Clinical Meetings, April 10-14, 2018, Austin, Texas.