Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria
Year: 2015
Type: article
Study design: Observational Study
Abstract: Transition from child to adult-oriented care is widely regarded a challenging period for young people with kidney transplants and is associated with a high risk of graft failure. We analyzed the existing transition structures in Germany and Austria using a questionnaire and retrospective data of 119 patients transferred in 2011 to 2012. Most centers (73%) confirmed agreements on the transition procedure. Patients' age at transfer was subject to regulation in 73% (18 years). Median age at transition was 18.3 years (16.5-36.7). Median serum creatinine increased from 123 to 132 μmol/L over the 12 month observation period before transfer (P = 0.002). A total of 25/119 patients showed increased creatinine ≥ 20% just before transfer. Biopsy proven rejection was found in 10/119 patients. Three patients lost their graft due to chronic graft nephropathy.Mean coefficient of variation (CoV%) of immunosuppression levels was 0.20 ± 0.1. Increased creatinine levels ≥ 20% just before transfer were less frequently seen in patients with CoV < 0.20 (P = 0.007). The majority of pediatric nephrology centers have internal agreements on transitional care. More than half of the patients had CoV of immunosuppression trough levels consistent with good adherence. Although, 20% of the patients showed increase in serum creatinine close to transfer.
Source: Medicine
Authors: Martin Kreuzer, Jenny Prüfe, Martina Oldhafer, Dirk Bethe, Marie-Luise Dierks, Silvia Müther, Julia Thumfart, Bernd Hoppe, Anja Büscher, Wolfgang Rascher, Matthias Hansen, Martin Pohl, Markus J. Kemper, Jens Drube, Susanne Rieger, Ulrike John, Christina Taylan, Katalin Dittrich, Sabine Hollenbach, Günter Klaus, Henry Fehrenbach, Birgitta Kranz, Carmen Montoya, Bärbel Lange-Sperandio, Bettina Ruckenbrodt, Heiko Billing, Hagen Staude, Krisztina Heindl-Rusai, Reinhard Brunkhorst, Lars Pape
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
Funder: KfH-Stiftung Präventivmedizin
OpenAlex ID: W2184777820