Kidney Research and Clinical Practice 2019 Mar; 38(1): 116-123  https://doi.org/10.23876/j.krcp.18.0068
Outcomes of end-stage renal disease patients on the waiting list for deceased donor kidney transplantation: A single-center study
Hong Jae Jeon1, Hong Jin Bae1, Young Rok Ham1, Dae Eun Choi1, Ki Ryang Na1, Moon-Sang Ahn2, Kang Wook Lee1
1Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea, 2Department of Surgery, Chungnam National University Hospital, Daejeon, Korea
Correspondence to: Kang Wook Lee, Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. E-mail: kwlee@cnu.ac.kr
ORCID: https://orcid.org/0000-0003-3407-1205
Received: July 3, 2018; Revised: November 8, 2018; Accepted: November 12, 2018; Published online: March 31, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Kidney transplantation is an effective renal replacement therapy for patients with end-stage renal disease (ESRD). In this study, we assessed the impact of the baseline characteristics and comorbidities of ESRD patients on the probability of deceased donor kidney transplantation (DDKT) and evaluated the morbidity and mortality during the time spent waiting.
Methods: The study population consisted of 544 ESRD patients on the waiting list for DDKT at Chungnam National University Hospital in South Korea between February 2000 and October 2015. The patients were observed from the date of transplantation list registration to the date of transplantation. Baseline characteristics and comorbidities were investigated together with new-onset comorbidities that occurred during the waiting time.
Results: Diabetes mellitus (39.0%), hypertension (25.2%), and glomerulonephritis (21.3%) were the three most common causes of ESRD in this study, and coronary artery disease (9.4%) was the most common comorbidity. The 115 patients (19.3%) who underwent DDKT had a mean waiting time of 1,711 days (768-2,654 days or 4.68 years [2.10-7.27]). Blood groups other than type O, peritoneal dialysis, and nondiabetic ESRD were significantly associated with a higher likelihood of DDKT. Infection was the leading cause of death and the most common comorbidity that arose during the waiting time. Patients who experienced cardiovascular events during the waiting time showed a lower transplant rate compared with those who did not.
Conclusion: The prevalence of comorbidities was high in renal transplantation candidates. During the often-long waiting time, new comorbidities may occur, with long-term sequelae limiting access to kidney transplantation or resulting in death.
Keywords: Comorbidity, End-stage renal disease, Kidney transplantation, Waiting lists


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