Work

Kidney transplantation outcomes in older adults: the influence of comorbidity burden

Year: 2026

Type: article

Abstract: Background and Hypothesis In France, ≥70-year-old patients represent 50% of all individuals starting kidney replacement therapy. In the absence of contraindications, kidney transplantation should be proposed up to the age of 85 years. The aim of this study was to evaluate the influence of age and comorbidities on the 1-year mortality rate after transplantation, length of hospital stay after transplantation, and readmission rates in older adults. Methods Cross-referencing clinical data from the Renal Epidemiology and Information Network (REIN) registry and healthcare utilization data from the French National Health Data (SNDS) database allowed identifying all ≥65-year-old patients who started kidney replacement therapy in France between January 1, 2017 and December 31, 2018, and who underwent a first kidney transplantation before December 31, 2020 (n = 749). Follow-up was to December 31, 2021. Cox proportional hazards models were used to analyze survival, and multilevel logistic regression models to evaluate hospitalization outcomes. Results In the ≥65-year-old patients identified (n = 749), the age group did not have an independent effect on 1-year survival rate. Conversely, age was correlated with longer initial hospitalization (OR = 2.15, 95% CI [1.3-3.5]) and longer cumulative hospital stay during the first year post-transplant (OR = 2.04, 95% CI [1.2-3.3]). Peripheral artery disease was associated with a nearly 2-fold increased risk of death during the first year following kidney transplantation (HR=1.97, 95% CI [1.02-3.82]). Conclusion While peripheral artery disease was associated with reduced 1-year survival after kidney transplantation, no significant association was found between age group and mortality. However, a trend toward lower survival was observed in recipients aged >75 years. In addition, older age was associated with prolonged initial hospitalization and rehospitalization in the first post-transplant year, potentially impacting quality of life.

Source: Kidney Diseases

DOI: 10.1159/kdd/adkag009