The benefit of kidney transplantation versus remaining on the waitlist depends on patients' baseline comorbidities: a retrospective study

Background: Patients with end-stage renal disease present comorbidities that increase mortality risk on the waitlist and after kidney transplantation. This study aimed to determine the impact of baseline comorbidities on the risk of death after kidney transplantation compared to remaining on the waitlist.

Methods: Records of waitlisted patients were retrospectively analyzed. Multivariable time-dependent Cox-regression model was used to determine the initial and the lowest relative hazard-risk of death (HRD) after exposure to kidney transplantation.

Results: 1692 patients were included in the study. Patients without comorbidities had the relative HRD 3-fold higher, immediately after kidney transplantation, but it reduced progressively, reaching equality to waitlist at 75 days and a HRD of 0.28 thereafter (p<0.001). Patients with Diabetes and coronary artery disease had an initial relative HRD of 2.41 (p=0.009) and 2.68 (p=0.009) and matched to the waitlist at 175 and 200 days, r...