A Retrospective Cohort Study of kidney transplantation in elderly renal patients with nephrolithiasis

Chiamaka Ndlovu; A. Banda; Z. Kamau

doi:10.5281/zenodo.22813039

Authors

Chiamaka Ndlovu Department of Clinical Renal Medicine, Arno Center for Renal Medicine Author https://orcid.org/8873-9149-1935-2467
A. Banda Department of Nephrology, Ebro Institute for Advanced Renal Medicine Author https://orcid.org/9996-1045-3439-1875
Z. Kamau Department of Nephrology, Mekong Center for Nephrology Author https://orcid.org/1993-2194-6149-3953

DOI:

https://doi.org/10.5281/zenodo.22813039

Keywords:

kidney transplantation, nephrolithiasis, elderly, graft survival, urolithiasis

Abstract

Graphical abstract

Background: Kidney transplantation confers a survival advantage over dialysis, but elderly candidates and those with nephrolithiasis have each raised distinct concerns about surgical risk and graft durability that have rarely been examined together [1,6]. Objective: To determine whether nephrolithiasis, present in the native kidney or diagnosed de novo in the allograft, affects perioperative course and mid-term graft outcomes among elderly kidney transplant recipients. Methods: We retrospectively analyzed 214 recipients aged 60 years or older, comparing 42 with documented nephrolithiasis and 172 without, using Kaplan-Meier and multivariable Cox regression for death-censored graft survival. Results: Urological re-intervention within one year was more frequent with nephrolithiasis (21.4% vs 4.7%, p<0.01), but five-year death-censored graft survival (83.3% vs 86.6%), rejection and eGFR did not differ significantly, and nephrolithiasis was not an independent predictor of graft loss after adjustment; delayed graft function was [7,12]. Conclusions: In carefully selected elderly recipients, nephrolithiasis increases the need for urological intervention but does not independently compromise mid-term graft survival, supporting active endourologic management rather than exclusion from transplantation on the basis of age or stone history [8,16].

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