Recipient-related predictors of kidney transplantation outcomes in the elderly

Background: It is not clear whether in old people with end- stage renal disease kidney transplantation is superior to dialysis therapy. Methods: We compared mortality rates between kidney transplant recipients (KTRs) and the general population across different age categories. We also examined patient and allograft survival in 15 667 elderly KTRs (65- 30 kg/m 2 ) was associated with 19% higher risk of graft failure (HR: 1.19 (1.07-1.33), p = 0.002). Diabetes was a predictor of worse patient survival in all age groups but poorer allograft outcome in the youngest age group (65-<70 yr old) only. None of the examined risk factors affected allograft outcome in the oldest group ( 75 yr old) although there was a 49% lower trend of graft failure in very old Hispanic recipients (HR: 0.51 (0.26-1.01), p = 0.05). Conclusions: Kidney transplantation may attenuate the age-associated increase in mortality, and its superior survival gain is most prominent in the oldest recipients ( 75 yr old). The potential protective effect of kidney transplantation on longevity in the elderly deserves further investigation.