Table 1.
Patient and donor characteristics at time of kidney transplantation, by cause of ESRD, among United States adult kidney transplant recipients with ESRD due to GN, DN, or ADPKD, 1996–2011 (n=107,778)
| Characteristics | Primary GN Subtypes | Secondary GN Subtypes | Non-GN Comparator Groups | |||||
|---|---|---|---|---|---|---|---|---|
| FSGS | IgAN | MN | MPGN | LN | Vasculitis | DN | ADPKD | |
| n=13,272 | n=7379 | n=2249 | n=1980 | n=5884 | n=1367 | n=57,190 | n=18,457 | |
| Age, yr | ||||||||
| Mean, SD | 43.9 (14.1) | 41.6 (12.6) | 49.3 (13.2) | 43.2 (14.4) | 38.3 (11.5) | 48.8 (15.1) | 52.3 (11.5) | 52.2 (9.5) |
| <40 | 5307 (40) | 3457 (46.8) | 523 (23.3) | 804 (40.6) | 3289 (55.9) | 366 (26.8) | 9285 (16.2) | 1535 (8.3) |
| 40–59 | 5933 (44.7) | 3223 (43.7) | 1164 (51.8) | 885 (44.7) | 2323 (39.5) | 618 (45.2) | 30,654 (53.6) | 12,864 (69.7) |
| 60–69 | 1621 (12.2) | 578 (7.8) | 467 (20.8) | 258 (13) | 246 (4.2) | 294 (21.5) | 14,702 (25.7) | 3403 (18.4) |
| 70+ | 411 (3.1) | 121 (1.6) | 95 (4.2) | 33 (1.7) | 26 (0.4) | 89 (6.5) | 2549 (4.5) | 655 (3.5) |
| Male sex | 8225 (62) | 5003 (67.8) | 1553 (69.1) | 1181 (59.6) | 1102 (18.7) | 752 (55) | 36,169 (63.2) | 10,081 (54.6) |
| Racea | ||||||||
| White | 7902 (59.5) | 5580 (75.6) | 1609 (71.5) | 1537 (77.6) | 2989 (50.8) | 1197 (87.6) | 39,530 (69.1) | 15,857 (85.9) |
| Black | 4575 (34.5) | 392 (5.3) | 512 (22.8) | 269 (13.6) | 2360 (40.1) | 97 (7.1) | 13,440 (23.5) | 1635 (8.9) |
| Asian | 585 (4.4) | 1219 (16.5) | 94 (4.2) | 137 (6.9) | 436 (7.4) | 54 (4) | 2629 (4.6) | 818 (4.4) |
| Other | 209 (1.6) | 188 (2.5) | 33 (1.5) | 37 (1.9) | 98 (1.7) | 19 (1.4) | 1584 (2.8) | 147 (0.8) |
| Hispanic ethnicity | 1246 (9.4) | 810 (11) | 244 (10.8) | 211 (10.7) | 969 (16.5) | 127 (9.3) | 8301 (14.5) | 1202 (6.5) |
| Missing | 384 (2.9) | 123 (1.7) | 46 (2.0) | 83 (4.2) | 187 (3.2) | 22 (1.6) | 3928 (6.9) | 1320 (7.2) |
| Geographic region | ||||||||
| Northeast | 2770 (20.9) | 1398 (18.9) | 514 (22.9) | 427 (21.6) | 1161 (19.7) | 272 (19.9) | 10,967 (19.2) | 3831 (20.8) |
| Midwest | 3166 (23.9) | 1838 (24.9) | 545 (24.2) | 527 (26.6) | 1154 (19.6) | 414 (30.3) | 14,289 (25.0) | 4578 (24.8) |
| South | 5155 (38.8) | 2177 (29.5) | 800 (35.6) | 650 (32.8) | 2252 (38.3) | 397 (29.0) | 19,887 (34.8) | 6283 (34) |
| West | 2181 (16.4) | 1966 (26.6) | 390 (17.3) | 376 (19) | 1317 (22.4) | 284 (20.8) | 12,047 (21.1) | 3765 (20.4) |
| Dialysis modality before transplantation | ||||||||
| None (pre-emptive) | 2080 (15.7) | 1540 (20.9) | 301 (13.4) | 326 (16.5) | 500 (8.5) | 122 (8.9) | 5459 (9.5) | 4562 (24.7) |
| Hemodialysis | 8397 (63.3) | 4049 (54.9) | 1467 (65.2) | 1216 (61.4) | 4174 (70.9) | 978 (71.5) | 42,267 (73.9) | 10,279 (55.7) |
| Peritoneal dialysis | 2350 (17.7) | 1400 (19) | 405 (18) | 358 (18.1) | 1071 (18.2) | 233 (17) | 7884 (13.8) | 2731 (14.8) |
| Missing | 445 (3.4) | 390 (5.3) | 76 (3.4) | 80 (4) | 139 (2.4) | 34 (2.5) | 1580 (2.8) | 885 (4.8) |
| Dialysis duration (vintage) before transplantation | ||||||||
| Median (IQR), d | 590 (162–1317) | 322 (48–911) | 600 (197–1285) | 506 (128–1148) | 929 (348–1730) | 697 (326–1326) | 703 (295–1307) | 407 (1–1030) |
| None (pre-emptive) | 2080 (15.7) | 1540 (20.9) | 301 (13.4) | 326 (16.5) | 500 (8.5) | 122 (8.9) | 5459 (9.5) | 4562 (24.7) |
| <1 yr | 2919 (22) | 2374 (32.2) | 524 (23.3) | 500 (25.3) | 1027 (17.5) | 250 (18.3) | 11,502 (20.1) | 4274 (23.2) |
| 1–3 yr | 4094 (30.8) | 1991 (27) | 741 (32.9) | 624 (31.5) | 1784 (30.3) | 546 (39.9) | 21,923 (38.3) | 5394 (29.2) |
| 3–5 yr | 2348 (17.7) | 946 (12.8) | 408 (18.1) | 289 (14.6) | 1222 (20.8) | 272 (19.9) | 11,417 (20.0) | 2602 (14.1) |
| >5 yr | 1831 (13.8) | 528 (7.2) | 275 (12.2) | 241 (12.2) | 1351 (23) | 177 (12.9) | 6889 (12.0) | 1625 (8.8) |
| Completed college | 5661 (42.7) | 3573 (48.4) | 860 (38.2) | 800 (40.4) | 2627 (44.6) | 573 (41.9) | 21,404 (37.4) | 8838 (47.9) |
| Missing | 2221 (16.7) | 1207 (16.4) | 410 (18.2) | 378 (19.1) | 1036 (17.6) | 222 (16.2) | 10,717 (18.7) | 3178 (17.2) |
| Insurance payer at transplanta | ||||||||
| Private | 6132 (46.2) | 4476 (60.7) | 1003 (44.6) | 919 (46.4) | 2172 (36.9) | 583 (42.6) | 22,066 (38.6) | 10,776 (58.4) |
| Medicaid | 575 (4.3) | 243 (3.3) | 86 (3.8) | 104 (5.3) | 349 (5.9) | 29 (2.1) | 2298 (4.0) | 369 (2.0) |
| Medicare | 6203 (46.7) | 2496 (33.8) | 1113 (49.5) | 900 (45.5) | 3244 (55.1) | 741 (54.2) | 31,657 (55.4) | 6905 (37.4) |
| Veterans Affairs | 85 (0.6) | 44 (0.6) | 16 (0.7) | 14 (0.7) | 11 (0.2) | 7 (0.5) | 355 (0.6) | 94 (0.5) |
| Other | 233 (1.8) | 98 (1.3) | 24 (1.1) | 27 (1.4) | 79 (1.3) | 6 (0.4) | 549 (1.0) | 248 (1.3) |
| Comorbidities | ||||||||
| Diabetes | 857 (6.5) | 273 (3.7) | 169 (7.5) | 125 (6.3) | 254 (4.3) | 90 (6.6) | 46,253 (80.9) | 760 (4.1) |
| Heart failure | 596 (4.5) | 220 (3) | 166 (7.4) | 107 (5.4) | 444 (7.5) | 66 (4.8) | 9607 (16.8) | 416 (2.3) |
| Coronary heart disease | 572 (4.3) | 181 (2.5) | 142 (6.3) | 72 (3.6) | 173 (2.9) | 54 (4.0) | 8256 (14.4) | 822 (4.5) |
| CVA/TIA | 165 (1.2) | 69 (0.9) | 31 (1.4) | 17 (0.9) | 163 (2.8) | 31 (2.3) | 2327 (4.1) | 350 (1.9) |
| Hypertension | 9526 (71.8) | 5729 (77.6) | 1602 (71.2) | 1374 (69.4) | 3937 (66.9) | 851 (62.3) | 42,519 (74.3) | 13,749 (74.5) |
| COPD | 206 (1.6) | 47 (0.6) | 47 (2.1) | 27 (1.4) | 30 (0.5) | 33 (2.4) | 934 (1.6) | 178 (1.0) |
| Current/recent smoker | 569 (4.3) | 212 (2.9) | 126 (5.6) | 90 (4.5) | 142 (2.4) | 37 (2.7) | 1931 (3.4) | 559 (3) |
| Cancer | 244 (1.8) | 74 (1) | 52 (2.3) | 45 (2.3) | 39 (0.7) | 29 (2.1) | 730 (1.3) | 310 (1.7) |
| PVD | 188 (1.4) | 59 (0.8) | 49 (2.2) | 29 (1.5) | 87 (1.5) | 29 (2.1) | 5885 (10.3) | 173 (0.9) |
| Nonambulant | 35 (0.3) | 10 (0.1) | <10 (<1.0) | <10 (<1.0) | 40 (0.7) | <10 (<1.0) | 365 (0.6) | 26 (0.1) |
| Missing | 568 (4.3) | 72 (1.0) | 121(5.4) | 95 (4.8) | 345 (6.2) | 49 (3.6) | 2551 (4.5) | 934(5.1) |
| HCV positive at transplant | 629 (4.7) | 122 (1.7) | 65 (2.9) | 197 (10.0) | 137 (2.3) | 25 (1.8) | 2815(4.9) | 403(2.2) |
| Missing | 1166 (8.8) | 591 (8.0) | 217 (9.7) | 192 (9.7) | 544 (8.0) | 128 (9.4) | 4918 (8.6) | 1598 (8.7) |
| BMI at transplant, kg/m2 | ||||||||
| Median (IQR) | 27.4 (23.6–31.8) | 26.3 (23.0–30.1) | 26.6 (23.6–30.6) | 24.9 (22.0–28.9) | 23.8 (21.0–27.8) | 25.7 (22.4–29.8) | 27.5 (24.1–31.6) | 26.5 (23.5–30.2) |
| Underweight (<18.5) | 352 (2.7) | 189 (2.6) | 28 (1.2) | 72 (3.6) | 360 (6.1) | 46 (3.4) | 727 (1.3) | 320 (1.7) |
| Normal (18.5–25) | 3627 (27.3) | 2535 (34.4) | 671 (29.8) | 774 (39.1) | 2600 (44.2) | 503 (36.8) | 14,287 (25.0) | 5818 (31.5) |
| Overweight (25–30) | 3834 (28.9) | 2217 (30) | 732 (32.5) | 506 (25.6) | 1389 (23.6) | 396 (29) | 17,375 (30.4) | 6063 (32.8) |
| Obese (>30) | 4044 (30.5) | 1761 (23.9) | 567 (25.2) | 371 (18.7) | 840 (14.3) | 312 (22.8) | 18,406 (32.2) | 4332 (23.5) |
| Missing | 1415 (10.7) | 677 (9.2) | 251 (11.2) | 257 (13) | 695 (11.8) | 110 (8) | 6395 (11.2) | 1924 (10.4) |
| Prior blood transfusion | 2246 (16.9) | 1092 (14.8) | 420 (18.7) | 427 (21.6) | 1918 (32.6) | 474 (34.7) | 13,206 (23.1) | 2764 (15.0) |
| Missing | 1783 (13.4) | 846 (11.5) | 350 (15.6) | 297 (15) | 843 (14.3) | 150 (11) | 7855 (13.7) | 2457 (13.3) |
| Recipient blood groupa | ||||||||
| O | 5901 (44.5) | 3311 (44.9) | 1020 (45.4) | 881 (44.5) | 2849 (48.4) | 617 (45.1) | 24,659 (43.1) | 8210 (44.5) |
| A | 4847 (36.5) | 2769 (37.5) | 818 (36.4) | 738 (37.3) | 1909 (32.4) | 563 (41.2) | 22,275 (38.9) | 7357 (39.9) |
| B | 1877 (14.1) | 941 (12.8) | 305 (13.6) | 253 (12.8) | 858 (14.6) | 132 (9.7) | 7109 (12.4) | 2035 (11.0) |
| AB | 614 (4.6) | 339 (4.6) | 103 (4.6) | 97 (4.9) | 246 (4.2) | 55 (4) | 2912 (5.1) | 821 (4.4) |
| Anti-HLA sensitization | ||||||||
| Median (IQR) | 0 (0–8) | 0 (0–5) | 0 (0–8) | 0 (0–10) | 5 (0–44) | 0 (0–10) | 0 (0–7) | 0 (0–19) |
| Low (PPRA<10%) | 8294 (62.5) | 4370 (59.2) | 1375 (61.1) | 1136 (57.4) | 2615 (44.4) | 794 (58.1) | 33,287 (58.2) | 11,435 (62.0) |
| Moderate (PPRA 10%–80%) | 1765 (13.3) | 737 (10) | 296 (13.2) | 266 (13.4) | 1405 (23.9) | 197 (14.4) | 6986 (12.2) | 2705 (14.7) |
| High (PPRA >80%) | 482 (3.6) | 180 (2.4) | 79 (3.5) | 88 (4.4) | 630 (10.7) | 54 (4) | 1905 (3.3) | 695 (3.8) |
| Missing | 2731 (20.6) | 2092 (28.4) | 499 (22.2) | 490 (24.7) | 1234 (21) | 322 (23.6) | 15,012 (26.2) | 3622 (19.6) |
| HLA mismatch | ||||||||
| 0 mismatch | 1387 (10.5) | 909 (12.3) | 271 (12) | 263 (13.3) | 749 (12.7) | 177 (12.9) | 6063 (10.6) | 2053 (11.1) |
| 1–3 mismatch | 4619 (34.8) | 2848 (38.6) | 819 (36.4) | 737 (37.2) | 2035 (34.6) | 547 (40) | 17,986 (31.4) | 5752 (31.2) |
| 4–6 mismatch | 7017 (52.9) | 3473 (47.1) | 1128 (50.2) | 915 (46.2) | 2971 (50.5) | 626 (45.8) | 31,875 (55.7) | 10,334 (56.0) |
| Missing | 249 (1.9) | 149 (2) | 31 (1.4) | 65 (3.3) | 129 (2.2) | 17 (1.2) | 1266 (2.2) | 318 (1.7) |
| Type of transplant | ||||||||
| Living | 5692 (42.9) | 4306 (58.4) | 982 (43.7) | 878 (44.3) | 2594 (44.1) | 685 (50.1) | 17,934 (31.4) | 7748 (42.0) |
| Standard deceased | 6060 (45.7) | 2502 (33.9) | 957 (42.6) | 864 (43.6) | 2721 (46.2) | 534 (39.1) | 29,034 (50.8) | 8179 (44.3) |
| Expanded criteria | 955 (7.2) | 336 (4.6) | 218 (9.7) | 134 (6.8) | 305 (5.2) | 103 (7.5) | 7023 (12.3) | 1662 (9.0) |
| Missing | 565 (4.3) | 235 (3.2) | 92 (4.1) | 104 (5.3) | 264 (4.5) | 45 (3.3) | 3199 (5.6) | 868 (4.7) |
| Cold ischemia time | ||||||||
| Mean (SD) | 10.2 (11.5) | 7.1 (10.5) | 10.2 (11.4) | 10.0 (11.5) | 10.0 (11.7) | 8.7 (10.9) | 12.1 (11.2) | 10.4 (11.4) |
| <12 h | 7237 (54.5) | 4979 (67.5) | 1217 (54.1) | 1106 (55.9) | 3264 (55.5) | 827 (60.5) | 26,495 (46.3) | 9841 (53.3) |
| 12–24 h | 3684 (27.8) | 1500 (20.3) | 618 (27.5) | 508 (25.7) | 1563 (26.6) | 329 (24.1) | 18,841 (32.9) | 5179 (28.1) |
| >24 h | 1738 (13.1) | 632 (8.6) | 305 (13.6) | 259 (13.1) | 762 (13) | 153 (11.2) | 8318 (14.5) | 2484 (13.5) |
| Missing | 613 (4.6) | 268 (3.6) | 109 (4.8) | 107 (5.4) | 295 (5) | 58 (4.2) | 3536 (6.2) | 953 (5.2) |
| Donor age, yr | ||||||||
| Mean (SD) | 38.1 (14.5) | 38.3 (13.8) | 39.8 (14.4) | 38.0 (14.5) | 36.7 (14.6) | 39.8 (14.5) | 39.1 (15.4) | 40.6 (14.8) |
| Missing | 569 (4.3) | 236 (3.2) | 93 (4.1) | 105 (5.3) | 270 (4.6) | 46 (3.4) | 3208 (5.6) | 870 (4.7) |
| Donor male sexa | 6791 (51.2) | 3598 (48.8) | 1144 (50.9) | 1018 (51.4) | 3137 (53.3) | 667 (48.8) | 30,129 (52.7) | 9275 (50.3) |
| Donor racea | ||||||||
| White | 9760 (73.5) | 5818 (78.8) | 1766 (78.5) | 1601 (80.9) | 3912 (66.5) | 1154 (84.4) | 44,008 (77.0) | 15,758 (85.4) |
| Black | 2238 (16.9) | 423 (5.7) | 273 (12.1) | 183 (9.2) | 1164 (19.8) | 97 (7.1) | 7076 (12.4) | 1399 (7.6) |
| Asian | 275 (2.1) | 436 (5.9) | 35 (1.6) | 54 (2.7) | 196 (3.3) | 14 (1) | 1223 (2.1) | 270 (1.5) |
| Other | 953 (7.2) | 681 (9.2) | 171 (7.6) | 127 (6.4) | 584 (9.9) | 102 (7.5) | 4624 (8.1) | 973 (5.3) |
| Initial immunosuppression | ||||||||
| Alemtuzumab | 1007 (7.6) | 551 (7.5) | 162 (7.2) | 128 (6.5) | 356 (6.1) | 104 (7.6) | 3721 (6.5) | 1319 (7.1) |
| Basiliximab | 2563 (19.3) | 1535 (20.8) | 461 (20.5) | 384 (19.4) | 1062 (18) | 272 (19.9) | 10,892 (19.0) | 3684 (20.0) |
| Daclizumab | 1295 (9.8) | 746 (10.1) | 220 (9.8) | 212 (10.7) | 588 (10) | 127 (9.3) | 5598 (9.8) | 1607 (8.7) |
| Thymoglobulin | 4976 (37.5) | 2552 (34.6) | 791 (35.2) | 652 (32.9) | 2304 (39.2) | 489 (35.8) | 19,698 (34.4) | 6407 (34.7) |
| Tacrolimus | 9128 (68.8) | 5172 (70.1) | 1491 (66.3) | 1322 (66.8) | 4193 (71.3) | 932 (68.2) | 38,088 (66.6) | 12,161 (65.9) |
| Ciclosporin | 3763 (28.4) | 2099 (28.4) | 677 (30.1) | 628 (31.7) | 1543 (26.2) | 363 (26.6) | 16,123 (28.2) | 5452 (29.5) |
| Sirolimus | 1089 (8.2) | 583 (7.9) | 204 (9.1) | 156 (7.9) | 427 (7.3) | 114 (8.3) | 4446 (7.8) | 1486 (8.1) |
| Mycophenolate | 11313 (85.2) | 6376 (86.4) | 1885 (83.8) | 1692 (85.5) | 5008 (85.1) | 1135 (83) | 47,861 (83.7) | 15,459 (83.8) |
| Azathioprine | 631 (4.8) | 356 (4.8) | 143 (6.4) | 133 (6.7) | 309 (5.3) | 79 (5.8) | 3482 (6.1) | 1090 (5.9) |
| Steroid | 12561 (94.6) | 6980 (94.6) | 2108 (93.7) | 1877 (94.8) | 5634 (95.8) | 1300 (95.1) | 53,919 (94.3) | 17,400 (94.3) |
| Missing | 186 (1.4) | 68 (0.9) | 30 (1.3) | 23 (1.2) | 83 (1.4) | 14 (1.0) | 964 (1.7) | 251 (1.4) |
| DGF | 2032 (15.3) | 662 (9.0) | 329 (14.6) | 267 (13.5) | 751 (12.8) | 163 (11.9) | 11,222 (17.6) | 2230 (12.1) |
| Missing DGF | 57 (0.4) | 31 (0.4) | 13 (0.6) | 21 (1.1) | 37 (0.6) | <10 (<0.5) | 6993 (10.9) | 75 (0.4) |
All values represent n (%) except where otherwise stated. DN, diabetic nephropathy; CVA, cerebrovascular accident; TIA, transient ischemic attack; COPD, chronic obstructive pulmonary disease; PVD, peripheral vascular disease; BMI, body mass index; HLA, human histocompatibility leukocyte antigen; PPRA, peak panel reactive antibody.
a
Missing n<1% for all GN subtypes.