Kidney transplant outcomes in recipients with visual, hearing, physical and walking impairments: a prospective cohort study.
Kidney transplant outcomes in recipients with visual, hearing, physical and walking impairments: a prospective cohort study.
复制标题
视力、听力、身体和行走障碍受者的肾移植结果：一项前瞻性队列研究。
DOI：
10.1093/ndt/gfz164
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
McAdams-DeMarco,Mara
中科院分区：
文献类型：
--
作者：
Thomas,AlvinG;Ruck,JessicaM;Chu,NadiaM;Agoons,Dayawa;Shaffer,AshtonA;Haugen,ChristineE;Swenor,Bonnielin;Norman,SilasP;Garonzik-Wang,Jacqueline;Segev,DorryL;McAdams-DeMarco,Mara
BackgroundDisability in general has been associated with poor outcomes in kidney transplant (KT) recipients. However, disability can be derived from various components, specifically visual, hearing, physical and walking impairments. Different impairments may compromise the patient through different mechanisms and might impact different aspects of KT outcomes.MethodsIn our prospective cohort study (June 2013–June 2017), 465 recipients reported hearing, visual, physical and walking impairments before KT. We used hybrid registry-augmented Cox regression, adjusting for confounders using the US KT population (Scientific Registry of Transplant Recipients,N= 66 891), to assess the independent association between impairments and post-KT outcomes [death-censored graft failure (DCGF) and mortality].ResultsIn our cohort of 465 recipients, 31.6% reported one or more impairments (hearing 9.3%, visual 16.6%, physical 9.1%, walking 12.1%). Visual impairment was associated with a 3.36-fold [95% confidence interval (CI) 1.17–9.65] higher DCGF risk, however, hearing [2.77 (95% CI 0.78–9.82)], physical [0.67 (95% CI 0.08–3.35)] and walking [0.50 (95% CI 0.06–3.89)] impairments were not. Walking impairment was associated with a 3.13-fold (95% CI 1.32–7.48) higher mortality risk, however, visual [1.20 (95% CI 0.48–2.98)], hearing [1.01 (95% CI 0.29–3.47)] and physical [1.16 (95% CI 0.34–3.94)] impairments were not.ConclusionsImpairments are common among KT recipients, yet only visual impairment and walking impairment are associated with adverse post-KT outcomes. Referring nephrologists and KT centers should identify recipients with visual and walking impairments who might benefit from targeted interventions pre-KT, additional supportive care and close post-KT monitoring.
