ABSTRACT Background Although kidney transplantation (KT) is associated with survival benefit compared with dialysis, even in older patients with end‐stage kidney disease (ESKD), the magnitude of this benefit, non‐mortality outcomes, and residual complications remain unclear. Comparisons with patients diagnosed with non‐dialysis‐dependent chronic kidney disease (CKD) can better clarify these issues. Methods Older KT recipients and patients with CKD were enrolled from a prospective nationwide database ( N = 817) and the National Health Insurance Service‐Senior Cohort Database ( N = 14,185), respectively. A 1:1 matching was performed. All‐cause mortality, cardiovascular events, progression to ESKD, infection‐related hospitalizations, and cancer were compared. Results Each group comprised 802 matched patients; 115 deaths, 25 cardiovascular events, 40 ESKD events, and 288 infection‐related hospitalizations occurred over a median follow‐up period of 88 months. Cumulative incidences of mortality and cardiovascular events were comparable between groups, whereas progression to ESKD and infection‐related hospitalizations were higher in older KT recipients than in patients with CKD. In multivariable Cox analysis, older KT recipients had similar risks of all‐cause mortality (adjusted hazard ratio HR 0.57, 95% confidence interval CI 0.33–1.01) and cardiovascular events (1.31, 0.42–4.05) to older patients with CKD but had increased risks of progression to ESKD (3.51, 1.07–11.5) and infection‐related hospitalizations (3.91, 2.66–5.74). HR of incident cancer was similar between groups (1.35, 0.75–2.46). Conclusions Older KT recipients did not demonstrate increased risks of all‐cause mortality, cardiovascular events, or incident cancer compared with the matched CKD population but had higher risks of kidney failure and infection‐related hospitalization.
Lee et al. (Sat,) studied this question.
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