Table 2.
Time-varying multivariable Cox proportional hazards for cumulative mortality in patients who received diabetic donor kidneys compared with the strategy of remaining on the waitlist or receiving a nondiabetic donor kidney (A) in the overall cohort, (B) divided by KDPI category, (C) when restricting to only patients willing to accept an ECD kidney, (D) when restricting to only patients who are always active on the waitlist, (E) when restricting to only patients who were waitlisted on or after 2004, (F) in candidates aged <40 years at the time of waitlisting, and (G) in candidates aged ≥40 years at the time of waitlisting
Exposure Groups | HRa | 95% CI | P Value |
---|---|---|---|
(A) Overall cohort (n=437,619) | |||
Waitlist or nondiabetic donor | REF | ||
Diabetic donor | 0.91 | 0.84 to 0.98 | 0.02 |
(B) Divided by KDPI risk category (n=437,619) | |||
Waitlist or nondiabetic donor, KDPI≤85% | REF | ||
Diabetic donor, KDPI≤85% | 0.76 | 0.68 to 0.85 | <0.001 |
Diabetic donor, KDPI>85% | 1.09 | 0.97 to 1.22 | 0.15 |
Nondiabetic donor, KDPI>85% | 0.86 | 0.81 to 0.91 | <0.001 |
(C) Candidate willing to accept ECD kidney (n=304,701) | |||
Waitlist or nondiabetic donor, KDPI≤85% | REF | ||
Diabetic donor, KDPI≤85% | 0.75 | 0.66 to 0.84 | <0.001 |
Diabetic donor, KDPI>85% | 1.10 | 0.98 to 1.24 | 0.10 |
Nondiabetic donor, KDPI>85% | 0.86 | 0.81 to 0.92 | <0.001 |
(D) Candidate always active on the waitlist (n=320,282) | |||
Waitlist or nondiabetic donor, KDPI≤85% | REF | ||
Diabetic donor, KDPI≤85% | 0.79 | 0.69 to 0.90 | <0.001 |
Diabetic donor, KDPI>85% | 1.19 | 1.04 to 1.36 | 0.01 |
Nondiabetic donor, KDPI>85% | 0.93 | 0.87 to 0.99 | 0.04 |
(E) Candidate waitlisted in 2004 or later (n=271,403) | |||
Waitlist or nondiabetic donor, KDPI≤85% | REF | ||
Diabetic donor, KDPI≤85% | 0.68 | 0.56 to 0.83 | <0.001 |
Diabetic donor, KDPI>85% | 1.17 | 0.98 to 1.40 | 0.09 |
Nondiabetic donor, KDPI>85% | 0.77 | 0.69 to 0.86 | <0.001 |
(F) Candidate age <40 yr (n=98,652) | |||
Waitlist or nondiabetic donor, KDPI≤85% | REF | ||
Diabetic donor, KDPI≤85% | 0.82 | 0.61 to 1.09 | 0.18 |
Diabetic donor, KDPI>85% | 1.12 | 0.76 to 1.65 | 0.57 |
Nondiabetic donor, KDPI>85% | 0.84 | 0.68 to 1.02 | 0.09 |
(G) Candidate age ≥40 yr (n=338,287) | |||
Waitlist or nondiabetic donor, KDPI≤85% | REF | ||
Diabetic donor, KDPI≤85% | 0.74 | 0.66 to 0.84 | <0.001 |
Diabetic donor, KDPI>85% | 1.04 | 0.92 to 1.17 | 0.51 |
Nondiabetic donor, KDPI>85% | 0.83 | 0.78 to 0.88 | <0.001 |
HR, hazard ratio; 95% CI, 95% confidence interval; REF, Reference group; KDPI, Kidney Donor Profile Index; ECD, Expanded criteria donor.
All multivariable models were adjusted for candidate diabetes status, center median waitlist time tertile, three-way interaction between donor diabetes status, candidate diabetes status, and center median waitlist time tertile, in addition to candidate age, sex, waitlist year, race, ABO blood type, panel reactive antibody, and dialysis vintage.