Differential Characteristics of Kidney Transplant Recipients According to 1‐Year Chronic Kidney Disease Stage 3a and Stage 3b Graft Function

The outcomes of transplantation have improved, but more than 50% of kidney transplantation (KT) recipients are still reported to have renal function of chronic kidney disease (CKD) stage 3 at 1 year after KT. We reviewed all 1235 patients who received a KT in our institution between 2008 and 2012. Among these recipients, 77 and 289 cases were included in the estimated glomerular filtration rate (eGFR) at 1 year after KT 30–44 (CKD stage 3b) group and eGFR 45–59 (CKD stage 3a) group, respectively. Longer duration of dialysis (odds ratio [OR] = 1.007, 95% confidence interval [CI], 1.000–1.014, P = 0.047), older donors (OR = 1.064, 95% CI, 1.031–1.098, P < 0.001), delayed graft function (OR = 3.601, 95% CI, 1.031–1.098, P < 0.001), BK virus infection (OR = 2.567, 95% CI, 1.242–5.305, P = 0.011), and pneumonia (OR = 4.451, 95% CI, 1.388–14.279, P = 0.012) were contributing factors to eGFR 30–44 mL/min. Especially, ureteral stricture occurred more frequently in eGFR 30–44 group of deceased donor KT. However, acute rejection was not a significant risk factor of lower eGFR. Graft survival was better in the eGFR 45–59 group. However, this difference was smaller in deceased donor KT. Infections and urologic complications are also important contributing factors of lower graft function in CKD stage 3. In addition, dividing CKD stage 3 into subgroups might be more useful in living donor kidney transplantation.