Mortality in kidney transplant recipients: a systematic review and meta-analysis of cohorts and clinical registries
- Authors: Novikova M.S.1,2, Minushkina L.O.1, Kotenko O.N.3,4, Zateyshchikov D.A.1,5, Boeva O.I.1, Allazova S.S.6, Shilov E.M.6
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Affiliations:
- Central State Medical Academy of the Administrative Department of the President of the Russian Federation
- Endocrinological Dispensary of the Moscow Healthcare Department
- Pirogov Russian National Research Medical University
- Peoples' Friendship University of Russia
- Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52
- Sechenov University
- Issue: Vol 15, No 1 (2023)
- Pages: 5-12
- Section: Original Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/430404
- DOI: https://doi.org/10.18565/nephrology.2023.1.5-12
- ID: 430404
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Abstract
Background. The number of kidney transplants and the number of recipients living with a kidney transplant continues to grow; approaches to the management of recipients in the late period after transplantation are changing. This requires a modern assessment of trends in post-transplant mortality.
Objective. Comparative assessment of the data on mortality in kidney transplant recipients (KTRs) received at the City Clinical Hospital № 52 of the Moscow Healthcare Department from 2016 to 2020 with a systematic analysis of published studies on this issue.
Material and methods. The electronic MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials databases were searched for eligible studies. All prospective and retrospective mortality studies with ≥ 50 KTR patients were considered eligible. A meta-analysis of proportions was performed using the Freeman-Tukey transform to calculate the weighted summary proportion under the fixed and random effects model. Of the total number of 187 studies found, 7 were included in the systematic review and meta-analysis, incl. and ours, with a total of 13,200 KTRs.
Results. In the analysis of 5-year survival, the proportion of deaths averaged 11.2% (fixed model) and 11.07% (random model). The mortality rate recorded in the Russian registry of the CCH № 52 of the Moscow Healthcare Department was lower (5.88%), however, in general, the meta-analysis data were not heterogeneous. The proportion of cardiovascular deaths in the studies analyzed was 0.87–3.3%, averaging 1.68% (fixed model), 1.91% (random model). The data were slightly heterogeneous. A greater variation was reported for the analysis of the incidence of death from sepsis or other infectious complications (0.8–6.0%), averaging 2.58% (fixed model) or 3.42% (random model). The scatter of data on the frequency of deaths from infectious complications was more heterogeneous, however, selection bias was detected in none of the cases.
Conclusion. This meta-analysis suggests that mortality in 2016–2020 among KTRs who lived for more than a year after kidney allotransplantation and were followed-up at the Moscow City Nephrological Center CCH № 52 of the Moscow Healthcare Department low than in the population of the same patients for the same period of time followed-up abroad. Given the limited number of enrolled patients and follow-up period, more research among KTRs is required.
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About the authors
Maria S. Novikova
Central State Medical Academy of the Administrative Department of the President of the Russian Federation; Endocrinological Dispensary of the Moscow Healthcare Department
Author for correspondence.
Email: citrus7474@mail.ru
Cand. Sci. (Med.), Associate Professor at the Department of Therapy, Cardiology and Functional Diagnostics with a Course of Nephrology, Central State Medical Academy of the Administrative Department of the President of the Russian Federation, Nephrologist at the Endocrinological Dispensary of the Moscow Healthcare Deparment
Russian Federation, Moscow; MoscowLarisa O. Minushkina
Central State Medical Academy of the Administrative Department of the President of the Russian Federation
Email: minushkina@mail.ru
Dr.Sci. (Med.), Professor at the Department of Therapy, Cardiology and Functional Diagnostics with a Course of Nephrology
Russian Federation, MoscowOleg N. Kotenko
Pirogov Russian National Research Medical University; Peoples' Friendship University of Russia
Email: olkotenko@yandex.ru
Cand. Sci. (Med.), Chief Specialist in Nephrology of the Moscow Healthcare Department, Head of the Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department
Russian Federation, Moscow; MoscowDmitry A. Zateyshchikov
Central State Medical Academy of the Administrative Department of the President of the Russian Federation; Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52
Email: dz@bk.ru
Dr. Sci. (Med.), Professor, Head of the Department of Therapy, Cardiology and Functional Diagnostics with a Course of Nephrology, Central State Medical Academy of the Administrative Department of the President of the Russian Federation, Head of the Primary Vascular Department, City Clinical Hospital № 29 n.a. N.E. Bauman of the Moscow Healthcare Department
Russian Federation, Moscow; MoscowOlga I. Boeva
Central State Medical Academy of the Administrative Department of the President of the Russian Federation
Email: citrus7474@mail.ru
Dr Sci. (Med.), Professor at the Department of Therapy, Cardiology and Functional Diagnostics with a Course of Nephrology
Russian Federation, MoscowSona S. Allazova
Sechenov University
Email: tallisasoto@rambler.ru
PhD student at the Department of Internal, Occupational Diseases and Rheumatology, Institute of Clinical Medicine n.a. N.V. Sklifosovsky
Russian Federation, MoscowEvgeny M. Shilov
Sechenov University
Email: emshilov@mma.ru
Dr. Sci. (Med.), Professor at the Department of Internal, Occupational Diseases and Rheumatology, Institute of Clinical Medicine n.a. N.V. Sklifosovsky
Russian Federation, MoscowReferences
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