TABLE 4.
Factors associated with insufficient humoral response to vaccine in KT recipients, defined as not reaching the 25th percentile of antibody levels
| Univariate |
Multivariate |
|||||
|---|---|---|---|---|---|---|
| OR | 95% CI | p-value | OR | 95% CI | p-value | |
| Sociodemographics | ||||||
| Age (years) | 1.030 | 0.99–1.06 | .08 | 1.01 | 0.97–1.05 | .38 |
| Sex (ref: female) | 0.49 | 0.20–1.17 | .10 | |||
| Body mass index (kg/m2) | 1.078 | 1.00–1.16 | .05 | 1.06 | 0.97–1.16 | .15 |
| Seasonal vaccine (ref: no) | 0.63 | 0.25–1.56 | .32 | |||
| Darbepoetin treatment (ref: no) | 9.94 | 1.20–82.21 | .03 | 5.96 | 0.59–54.41 | .13 |
| Vitamin D supplementation (ref: no) | 2.90 | 0.93–8.99 | .07 | 2.90 | 0.81–10.43 | .10 |
| Comorbidities | ||||||
| Hypertension | 1.09 | 0.06–18.06 | .94 | |||
| Diabetes mellitus | 1.13 | 0.48–2.62 | .77 | |||
| Cardiovascular disease | 1.87 | 0.36–2.06 | .75 | |||
| Pulmonary disease | 1.57 | 0.57–4.51 | .40 | |||
| Underlying diabetic nephropathy | 1.57 | 0.15–2.18 | .41 | |||
| Blood tests | ||||||
| White blood cells (×103 U/µl) | 0.87 | 0.73–1.034 | .11 | |||
| T lymphocytes (×103 U/µl) | 0.74 | 0.48–1.12 | .16 | |||
| C-reactive protein (mg/dl) | 1.012 | 0.66–1.54 | .95 | |||
| Albumin (g/dl) | 0.75 | 0.31–1.81 | .53 | |||
| Transplantation characteristics | ||||||
| Time after transplantation (months)a | 0.99 | 0.983–0.998 | .009 | 0.99 | 0.98–0.99 | .012 |
| Transplantation >1 yeara | 0.21 | 0.07–0.61 | .004 | 0.16 | 0.50–0.57 | .004 |
| Transplantation >6 monthsa | 0.11 | 0.24–0.54 | .006 | 0.60 | 0.01–0.33 | .001 |
| Serum creatinine (mg/dl)b | 1.94 | 0.98–3.85 | .05 | 1.45 | 0.64–3.28 | .37 |
| eGFR (ml/min per 1.73 m2)b | 0.97 | 0.95–0.99 | .01 | 0.98 | 0.95–1.005 | .12 |
| Immunosuppression treatment | ||||||
| Prednisonec | — | — | — | |||
| Mycophenolic acid | 1.07 | 0.46–2.47 | .86 | |||
| Tacrolimus or cyclosporin A | 5.11 | 0.54–47.73 | .15 | |||
| Tacrolimus dose (mg/kg/day) | 0.037 | 0.001–8.35 | .24 | |||
| Tacrolimus blood levels (ng/ml) | 1.96 | 0.93–1.02 | .32 | |||
| Everolimus | 1.13 | 0.43–2.96 | .80 | |||
| Everolimus dose (mg/kg/day) | 0.47 | 0.01–3.32 | .97 | |||
| Everolimus blood levels (ng/ml) | 1.44 | 0.68–3.04 | .33 | |||
Bold values indicate statistically significant p values (p < .05).
Abbreviations: CI, confidence interval; eGFR, estimated glomerular filtration rate; KT, kidney transplant; OR, odds ratio.
a
Different multivariate models maintain the three different variables within the model, all significant: months after transplant (continuous variable), KT of more than a year or KT of more than 6 months.
b
Not significant either including serum creatinine or eGFR.
c
Impossible to calculate, as patients negative without prednisone were = 0.