{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T17:35:53Z","timestamp":1771695353374,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney disease significantly increases the risk of dementia, including among kidney transplant (KTx) recipients. To date, the cost implications of dementia after KTx are not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective cohort study of US Renal Data System (USRDS) data (2006\u20132020) to estimate cost of care for \u226565\u2010year\u2010old Medicare insured KTx recipients (2006\u20132020) with newly diagnosed dementia (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a03285), compared to propensity\u2010matched controls without dementia (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a06570). KTx recipients age 65+ years with post\u2010KTx dementia were identified by diagnosis codes, and costs were computed based on payments on Medicare claims. Average costs per month, marginal costs per month, and cumulative costs were compared after dementia diagnosis versus after the equivalent time post\u2010KTx in controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Dementia was diagnosed at a mean of 5.1\u00a0\u00b1\u00a03.4 years post\u2010KTx. Patients' characteristics were well matched in cases versus controls, including age (mean: 70.1\u00a0vs. 69.9 years), sex (38.4%\u00a0vs. 37.9% women), race (23.7%\u00a0vs. 22.2% African American), and cause of ESKD (45.4%\u00a0vs. 43.7% diabetes). Over 4 years post\u2010KTx, dementia was associated with reduced survival (27%\u00a0vs. 68%) along with $66\u00a0145 (95% CI $51\u00a0560\u2010$78\u00a0489) higher Medicare spending. Average monthly costs in dementia patients reached a maximum of $12\u00a0713 and exceeded the cost of unaffected patients by up to $9789 per month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Post\u2010KTx dementia dramatically increased resource utilization and reduced post\u2010KTx surivival. These findings highlight the need for care pathways that better integrate cognitive health assessment and management into the care of KTx candidates and recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70189","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T08:55:29Z","timestamp":1748854529000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Economic Impact of Dementia After Kidney Transplantation: A Matched Cohort Analysis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-4849","authenticated-orcid":false,"given":"Krista L.","family":"Lentine","sequence":"first","affiliation":[{"name":"Saint Louis University Transplant Center, SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1591-0862","authenticated-orcid":false,"given":"Melissa L.","family":"Swee","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-9711","authenticated-orcid":false,"given":"Wisit","family":"Cheungpasitporn","sequence":"additional","affiliation":[{"name":"Transplant Nephrology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiling","family":"Xiao","sequence":"additional","affiliation":[{"name":"Saint Louis University Transplant Center, SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6486-4666","authenticated-orcid":false,"given":"Yasar","family":"Caliskan","sequence":"additional","affiliation":[{"name":"Saint Louis University Transplant Center, SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3013-925X","authenticated-orcid":false,"given":"Mara","family":"McAdams\u2010DeMarco","sequence":"additional","affiliation":[{"name":"Transplant Institute New York University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusi","family":"Chen","sequence":"additional","affiliation":[{"name":"Transplant Institute New York University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0098-8816","authenticated-orcid":false,"given":"Sunjae","family":"Bae","sequence":"additional","affiliation":[{"name":"Transplant Institute New York University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-4801","authenticated-orcid":false,"given":"Dorry","family":"Segev","sequence":"additional","affiliation":[{"name":"Transplant Institute New York University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5684-0613","authenticated-orcid":false,"given":"David","family":"Axelrod","sequence":"additional","affiliation":[{"name":"Transplant Surgery University Hospital  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8547-5643","authenticated-orcid":false,"given":"Mark","family":"Schnitzler","sequence":"additional","affiliation":[{"name":"Saint Louis University Transplant Center, SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.34971"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000000968"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12640\u2010019\u201000062\u20106"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000521907"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2016080816"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40472\u2010020\u201000284\u20100"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.10.014"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.21.182"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_9_11_1","volume-title":"2023 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States","author":"U.S. Renal Data System","year":"2023"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000002431"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13476"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010023\u201010095\u20105"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glad003"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010017\u20100221\u20100"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p754"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneph.2023.1238501"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2310142"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/0886022x.2024.2306232"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19042389"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581\u2010020\u20100266\u20109"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000004779"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620\u2010022\u201001376\u2010z"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24984"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3233\/jad\u2010150065"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl385"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/txd.0000000000000976"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70189","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:14:14Z","timestamp":1769724854000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/ctr.70189"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70189","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-03-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70189"}}