• Maria Aurora Posadas Salas, Rafael David Rodriguez-Abreu, Prince Amaechi, Vinaya Rao, Karim Soliman, and David Taber.
• Division of Nephrology and Hypertension, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States.
• Am. J. Med. Sci. 2021 Aug 1; 362 (2): 130-134.

BackgroundOlder kidney transplant recipients (OKTR) are vulnerable to infections and AKI, often prompting hospitalization. This study elucidates etiology of hospitalizations, AKI, and outcomes in OKTR.MethodsRetrospective study of 500 patients age ≥ 60, who underwent kidney transplantation from 2005-2015. Demographic, transplant, and outcomes data were collected.ResultsOKTR had mean age 66 years; 59% males and 50% African Americans. 62% had at least one hospitalization post-transplant. Predictors of hospitalization were DGF, DM, panel reactive antibodies (PRA), dialysis duration. Hospitalization was mostly due to infection and surgical complications. Average length of stay was 6.4 days. OKTR with at least one hospitalization had 84% higher risk for graft loss (p=0.001). 56% of older kidney transplant recipients had at least one AKI episode post-transplant. Predictors of AKI included DGF, older, African American donor, and tacrolimus variability. The most common etiologies for AKI were infection, dehydration, and GI complications. OKTR with at least one AKI episode had 2.6-fold higher risk for graft loss (p<0.001).ConclusionsPost-transplant hospitalization and AKI in OKTR significantly impact graft survival. Addressing comorbidities and risks in the pre-transplant and outpatient setting may help alleviate burden of hospitalization and risk of AKI in OKTR and improve graft outcomes.Copyright © 2021 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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