Compliance as an important predictor of renal transplantation outcomes

Although renal transplantation has been firmly established in routine clinical practice as the optimal modality of renal replacement therapy, the results are far from perfect. Aim. To investigate the impact of patient compliance on the outcomes of renal transplantation. Material and methods. The study comprised 260 renal allograft recipients with mean age of 36.2±0,6 years including 162 (62.3%) male patients. The mean follow-up was 92.9±3.7 months. Among the study participants 88 (33.8%) were noncompliant. The study investigated the impact of compliance on both patient and renal allograft survival and on the development of chronic graft dysfunction. We used univariate methods (descriptive statistics, correlation analysis) and multivariate analysis (logistic and Cox regression models). Results. Noncompliance was considerably prevalent (33.8%) in this patient cohort. The survival of patients and grafts in the group of noncompliant patients was significantly lower than among compliant participants (p<0.01). Correlation analysis showed the relationship of compliance with chronic graft dysfunction, transplant rejection crises, smoking after transplantation and vocational rehabilitation in the post-transplant period (p<0.05). Multivariate analysis showed the importance of compliance as a predictor of renal transplantation outcomes at one year after the operation regarding patient survival, renal transplant functioning and chronic graft dysfunction (p<0.05). Conclusion. Compliance of renal transplant recipients is an independent significant predictor of renal allograft outcomes influencing survival of both recipients and renal allografts and the development of chronic graft dysfunction.

compliance, renal allotransplantation, renal allograft, recipient, outcomes, survival, predictor