Determining the effect of immunosuppressant adherence on graft failure risk among renal transplant recipients

The objective was to use the United States Renal Data System (USRDS) to quantify the relationship between immunosuppressant therapy (IST) adherence and risk of graft failure among adult renal transplant recipients (RTRs). A secondary objective was to examine the relationship among select patient cha...

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Bibliographic Details
Published in:Clinical transplantation 2014-01, Vol.28 (1), p.96-104
Main Authors: Spivey, Christina A., Chisholm-Burns, Marie A., Damadzadeh, Bita, Billheimer, Dean
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Female
Follow-Up Studies
graft failure
Graft Rejection - prevention & control
Humans
immunosuppressant adherence
Immunosuppressive Agents - therapeutic use
Kidney Failure, Chronic - surgery
Kidney Transplantation
Male
Medication Adherence
Middle Aged
national data registry
Prognosis
renal transplant
Retrospective Studies
Risk Factors
Young Adult
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Summary:The objective was to use the United States Renal Data System (USRDS) to quantify the relationship between immunosuppressant therapy (IST) adherence and risk of graft failure among adult renal transplant recipients (RTRs). A secondary objective was to examine the relationship among select patient characteristics and IST adherence. The study sample included adult RTRs who: received primary transplant between January 1, 1999 and December 31, 2005; experienced graft survival for at least 12 months post‐transplant and had at least 12 months of data in the USRDS; utilized Medicare coverage for IST; and were prescribed cyclosporine or tacrolimus. IST adherence was measured by medication possession ratio (MPR). Pearson chi‐square tests were used to examine associations between patient characteristics and MPR quartiles. Cox proportional hazards regression was used to assess relationships among time to graft failure, MPR, and patient characteristics. Thirty‐one thousand nine hundred and thirteen RTRs met inclusion criteria. Older age, female gender, white race, deceased donors, and tacrolimus were associated with greater adherence (p 
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.12283