UK Renal Registry 12th Annual Report (December 2009): chapter 5: demographic and biochemistry profile of kidney transplant recipients in the UK in 2008: national and centre-specific analyses.

Abstract

National renal transplant registries routinely report on centre-specific patient and graft survival following renal transplantation. However, other outcomes such as graft function (as measured by eGFR), haemoglobin and blood pressure are also important indicators of quality of care. Transplant activity and incident graft survival data were obtained from NHS Blood and Trans-plant, laboratory and clinical variables and prevalent survival data were obtained from the UK Renal Registry. Data were analysed separately for prevalent and one year post-transplant patients. Increasing live and nonheartbeating donors were responsible for the increasing transplant activity. Graft failure occurred in 2.9% of prevalent transplant patients and death rates remained stable at 2.4/100 patient years. In transplant recipients with a specified cause of death, 21% died due to malignancy and 21% as a consequence of cardiac disease. There was centre variation in outcomes including eGFR and haemoglobin in prevalent and 1 year post-transplant recipients. Analysis of prevalent transplants by chronic kidney disease stage showed 14.7% with an eGFR <30 ml/min/1.73 m(2) and 2.1% <15 ml/min/1.73 m(2). Of those with CKD stage 5T, 40.4% had Hb concentrations <10.5 g/dl, 25.9% phosphate concentrations >or=1.8 mmol/L, 9.0% adjusted calcium concentrations >or=2.6 mmol/L and 40.8% PTH concentrations >or=32 pmol/L. With the exception of PTH, transplant recipients with CKD stage 5T were less likely to achieve the UK standards compared to prevalent dialysis patients. Wide variations in clinical and biochemical outcomes amongst transplant recipients continue to exist and may reflect differences in healthcare delivery across the UK. (c) 2010 S. Karger AG, Basel.