Chronic kidney disease management: comparison between renal transplant recipients and nontransplant patients with chronic kidney disease

Background/aim: Renal transplant recipients (RTR) and patients with native chronic kidney disease (CKD) have similar complications. It is not known how the management of CKD in RTR differs from that of patients with native CKD. This study compares the management of complications related to CKD between RTR and patients with native CKD.

Methods: Cross-sectional study of all RTR with stage 4 or 5 CKD (n = 72). The control group consisted of 72 native CKD patients matched by glomerular filtration rate (within 2 ml/min/1.73 m(2)). Multivariate logistic regression analysis was performed to account for potential confounding variables.

Results: Multivariate analysis revealed RTR to more likely have uncontrolled hypertension (adjusted odds ratio AOR 3.8; 95% confidence interval CI 1.3-10.7), less likely to be on angiotensin-converting enzyme inhibitors (AOR 0.11; 95% CI 0.04-0.32), more likely to be anemic and not be on erythropoietin (AOR 6.4; 95% CI 0.99-41.9), and more likely to have dyslipidemia and not be on statin (AOR 4.3; 95% CI 1.4-13.4).

Conclusions: This study suggests that the management of non-RTR in a multidisciplinary CKD clinic differs significantly from the CKD management in a traditional transplant clinic. A disease management approach like a multidisciplinary clinic may be an appropriate model for the future.