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Archives of Medical Science
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4/2018
vol. 14
 
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abstract:
Letter to the Editor

Comorbidities on kidney transplantation waiting list relative to the status of the potential recipient

Jolanta Malyszko, Teresa Dryl-Rydzynska, Wojciech Marcinkowski, Tomasz Prystacki, Jacek S. Malyszko

Arch Med Sci 2018; 14, 4: 941–944
Online publish date: 2016/06/01
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Kidney transplantation is the treatment of choice for most patients with end-stage renal disease (ESRD) [1, 2]. As patients with kidney disease often have significant comorbidities [3], the evaluation of a potential kidney transplant recipient should be as efficient and cost-effective as possible. The initial evaluation of the potential recipient should include a thorough medical, surgical, and psychosocial history and a detailed physical examination to identify comorbidities that could affect candidate survival after the transplantation. It should be stressed that a patient put on the waiting list for transplantation all the time is suffering from the same disease, and after waiting for the transplantation for several years it is not the same as it was at the moment of evaluation.
The aim of this study was to examine demographic and comorbidity factors of patients with end-stage renal disease on the kidney transplantation waiting list in regard to their status (active vs. temporarily disqualified).
The study was conducted on 300 potential kidney transplant recipients (40% females) from 26 dialysis centers in Poland representing 9.7% of all dialyzed patients in these units. Enlisted patients were aged 49 ±13 (35% were < 50 years). Prevalence of hepatitis B (1.5%) and C (3%) was very low. The cause of end-stage renal failure was hypertensive nephropathy in 29%, chronic glomerulonephritis in 29% and diabetic nephropathy in 25%. Data analyzed were based on the clinical and laboratory parameters in the registration form for kidney transplantation.
Basal clinical and biochemical characteristics of the patients in the active and inactive group are presented in Table I. Blood types B and AB were more common in patients on the active list compared to the inactive list (28% vs. 13%, p < 0.05 and 5% vs. 1%, p < 0.05, respectively). Causes of end-stage kidney disease and prevalence of the most common comorbidities, i.e. coronary heart disease, chronic heart failure, hypertension and diabetes, were similar between the two studied groups. Similarly, hepatitis B and C were more prevalent in patients on the inactive list compared to the active list (3.0% vs. 1.5%, p < 0.05, for both). Moreover, hypotensive drug treatment was used in a similar proportion in both groups, with calcium channel blockers being the most prevalent. Statin and acetylsalicylic acid were used in similar proportion in both groups (50% for statins and 48–49% for...


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