Researchers discovered that deaths among kidney transplant recipients due to factors other than organ rejection is the leading cause for transplanted kidney loss. Their findings, published in Transplantation Direct, revealed that only one in four transplanted kidney losses were caused by organ rejection.
“Immunosuppression medication to prevent rejection is often the focus when caring for patients post transplant. But this study highlights the increased risk of death from cancer and infection for transplant patients, especially those who are older and have diabetes,” said Andrew Bentall, MB, ChB, MD, the study’s co-first author.
The study involved 5752 patients who underwent a kidney transplant between 2006 and 2018. Of those, 691 died with a functioning kidney. Researchers found that 20% of these patients died from cancer; 19.7%, infection; and 12.6%, cardiac disease.
Another 553 patients lost their transplant due to the failure of a transplanted kidney. Of these patients, 38.7% of the patients’ kidneys failed due to rejection; 18.6%, glomerular diseases; and 13.9%, tubular injury.
Two types of recipients were found to be most vulnerable after transplant. The first are younger, nondiabetic patients who develop kidney failure due to organ rejection. The second group includes older, often diabetic patients who are at risk of death due to causes not associated with organ rejection, including cancer, infections and heart disease.
Care providers need to treat these two populations differently to minimise risks, according to Dr Bentall. For younger patients, that includes focusing on immunosuppression medication to prevent rejection. For older, often diabetic patients, it is critical to address chronic health issues, such as obesity, high blood pressure and diabetes. Focusing on these lifestyle changes is critical for improving long-term outcomes for kidney transplant recipients.
“It is important for these older patients that care providers emphasise the need for ongoing lifestyle changes that address obesity, high blood pressure and diabetes. Those include losing weight, exercising and new strategies for managing diabetes,” he said. “Making those changes could potentially impact the patient’s life and kidney outcomes more than immunosuppression therapies.”
Source: Mayo Clinic
