TABLE 4.
Cross-sectional clinical characteristics of the different cause of GF
| Clinical characteristics | Alloimmunen = 214 (Reference group) | Glomerular diseasen = 103 | Renal tubular injuries n = 77 | BK nephropatHy n = 24 | Unknown/Othern = 56 | ||||
|---|---|---|---|---|---|---|---|---|---|
| n (%), OR mean (SD) | n (%), OR mean (SD) | P | n (%), OR mean (SD) | P | n (%), OR mean (SD) | P | n (%), OR mean (SD) | P | |
| Age of the recipient at donation | 44.7 ± 14.9 | 48.9 ± 14.2 | 0.02 | 58.1 ± 11.2 | <0.001 | 54.7 ± 14.2 | 0.002 | 51.6 ± 14.6 | 0.002 |
| Sex (male) | 121 (56.5) | 71 (68.9) | 0.03 | 47 (61.0) | 0.46 | 20 (83.3) | 0.01 | 35 (62.5) | 0.39 |
| Time from transplantation | 4.6 ± 2.9 | 4.3 ± 3.2 | 0.41 | 4.2 ± 3.0 | 0.44 | 4.2 ± 3.2 | 0.52 | 5.1 ± 2.9 | 0.25 |
| Living donor | 98 (45.8) | 58 (56.3) | 0.08 | 28 (36.3) | 0.21 | 8 (33.3) | 0.24 | 17 (30.4) | 0.04 |
| Donor related | 39 (18.4) | 31 (30.1) | 0.02 | 14 (18.2) | 0.83 | 3 (12.5) | 0.47 | 14 (25) | 0.27 |
| Donor age (y) | 41.7 ± 14.8 | 42.1 ±15.5 | 0.82 | 47.6 ±14.4 | 0.003 | 47.6 ±14.4 | 0.06 | 43.0 ±16.0 | 0.57 |
| Recipient race | |||||||||
| White | 128 (59.8) | 69 (67) | 0.22 | 53 (68.9) | 0.16 | 12 (50) | 0.36 | 32 (57.1) | 0.71 |
| African-American | 52 (24.3) | 19 (18.4) | 0.24 | 8 (10.4) | 0.01 | 9 (37.5) | 0.16 | 12 (21.4) | 0.65 |
| Hispanics | 13 (6.1) | 4 (3.9) | 0.42 | 10 (13.0) | 0.04 | 1 (4.2) | 0.71 | 8 (14.3) | 0.04 |
| Others | 21 (9.8) | 11 (10.7) | 0.80 | 6 (7.8) | 0.27 | 2 (8.3) | 0.81 | 1 (1.8) | 0.20 |
| Donor sex (male) | 90 (42.0) | 54 (52.4) | 0.08 | 44 (57.1) | 0.02 | 10 (41.7) | 0.97 | 27 (48.2) | 0.41 |
| Diabetes as a cause of ESRD | 44 (20.6) | 21 (20.4) | 0.97 | 35 (45.5) | <0.001 | 8 (33.3) | 0.15 | 18 (32.1) | 0.07 |
| Dialysis | 178 (83.2) | 86 (83.5) | 0.98 | 61 (79.2) | 0.43 | 18 (75) | 0.32 | 44 (78.5) | 0.41 |
| Prednisone therapy | 113 (52.8) | 48 (46.6) | 0.30 | 42 (54.5) | 0.80 | 10 (41.7) | 0.30 | 29 (51.8) | 0.89 |
| HLA mismatch (A, B, DR) | 4.1 ± 1.43 | 3.8 ± 1.8 | 0.11 | 3.5±1.9 | 0.004 | 4.5+1.2 | 0.19 | 3.6 ± 1.7 | 0.03 |
| Induction | |||||||||
| Alemtuzumab | 79 (36.9) | 49 (47.6) | 0.07 | 27 (35.1) | 0.78 | 9 (37.5) | 0.95 | 18 (32.1) | 0.51 |
| Thymoglobulin | 107 (50.5) | 43 (41.2) | 0.12 | 16 (20.8) | <0.001 | 12 (50) | 0.96 | 29 (51.8) | 0.86 |
| Anti-CD25 | 28 (13.1) | 11 (10.7) | 0.54 | 34 (44.2) | <0.001 | 3 (12.5) | 0.93 | 9 (16.1) | 0.56 |
| Clinical factors | |||||||||
| History of any episode of cellular rejection | 169 (79.0) | 34 (33.6) | <0.001 | 20 (26) | <0.001 | 10 (41.6) | <0.001 | 17 (30.4) | <0.001 |
| History of any episode of acute antibody-mediated rejection | 103 (48.6) | 7(6.8) | <0.001 | 1 (1.3) | <0.001 | 2 (8.3) | <0.001 | 2 (3.6) | <0.001 |
| History of any episode of chronic antibody-mediated rejection | 115 (54.0) | 8 (7.8) | <0.001 | 2 (3.6) | <0.001 | 1 (4.2) | <0.001 | 6 (10.7) | <0.001 |
| History of nonskin cancer | 13 (6.1) | 10 (9.8) | 0.24 | 9 (11.7) | 0.11 | 2(8.3) | 0.68 | 2(3.6) | 0.47 |
| History of skin cancer | 13 (6.1) | 15 (14.7) | 0.01 | 10 (13.0) | 0.06 | 3(12.5) | 0.24 | 10 (17.9) | 0.005 |
| History of BK viremia | 49 (22.3) | 15 (14.7) | 0.11 | 17 (22.7) | 0.94 | 24 (100) | <0.001 | 9 (16.1) | 0.31 |
| History of BK nephropathy | 22 (10.3) | 6 (5.9) | 0.20 | 4 (5.2) | 0.18 | 24 (100) | <0.001 | 5 (8.9) | 0.76 |
| CMV viremia | 25 (11.7) | 18 (17.6) | 0.15 | 10(3.0) | 0.03 | 6 (25) | 0.07 | 6 (10.7) | 0.83 |
| History of recurrent diarrhea | 65 (30.4) | 35 (34.3) | 0.49 | 28 (36.4) | 0.33 | 9 (37.5) | 0.48 | 9 (10.6) | 0.003 |
| History of nonadherence | 85 (39.7) | 15 (14.7) | <0.001 | 9 (11.7) | <0.001 | 2 (8.3) | 0.003 | 6 (10.7) | <0.001 |
| Immunosuppression reduced by physician | 109 (51.2) | 43 (42.2) | 0.15 | 39 (50.6) | 0.59 | 24 (100) | <0.001 | 22 (39.3) | <0.001 |
| Death after graft failed | 38 (17.8) | 21 (20.4) | 0.58 | 36 (46.7) | <0.001 | 5 (20.8) | 0.125 | 14 (25) | 0.23 |
| De novo DSA | 117/197(59.3) | 15/90(16.9) | <0.001 | 5/71 (7) | <0.001 | 4/18 (22.2) | <0.001 | 4/45 (7.1) | <0.001 |
| De novo DSA class I only | 11 (5.6) | 1 (1) | 0.07 | 1 (1.3) | 0.14 | 1 (5.6) | 0.95 | 0 (0) | 0.11 |
| De novo DSA class II only | 67 (34.0) | 10 (9.9) | <0.001 | 4 (5.3) | <0.001 | 2 (11.1) | 0.04 | 3 (6.7) | 0.002 |
| Both de novo DSA class I and class II | 34 (17.3) | 4 (4) | 0.002 | 0 (0) | <0.001 | 1 (5.6) | 0.20 | 1 (2.2) | <0.001 |
| Unknown class DSA (not specified in the chart) | 5 (2.5) | 0 | – | 0 | – | 0 | – | 0 | – |
Comparison of each cause of GF compared with alloimmune graft loss reveals different profiles of patient in each category.
BK, polyoma virus; DSA, donor specific antibody; ESRD, end-stage renal disease; GF, graft failure; OR, odds ratio.