{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:09:15Z","timestamp":1793257755234,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","funder":[{"DOI":"10.13039\/100020335","name":"Angion Biomedica","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100020335","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2022,4,28]]},"abstract":"\n Background<\/jats:title>\n Estimated glomerular filtration rate (eGFR) at 1 year post transplantation has been shown to be a strong predictor of long-term graft survival. However, intercurrent events (ICEs) may affect the relationship between eGFR and failure risk.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The OPTN and USRDS databases on single-organ kidney transplant recipients from 2012 to 2016 were linked. Competing risk regressions estimated adjusted subhazard ratios (SHRs) of 12-month eGFR on long-term graft failure, considering all-cause mortality as the competing risk, for deceased donor (DD) and living donor (LD) recipients. Additional predictors included recipient, donor, and transplant characteristics. ICEs examined were acute rejection, cardiovascular events, and infections.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Cohorts comprised 25,131 DD recipients and 7471 LD recipients. SHRs for graft failure increased rapidly as 12-month eGFR values decreased from the reference 60 ml\/min per 1.73 m\n 2<\/jats:sup>\n . At an eGFR of 20 ml\/min per 1.73 m\n 2<\/jats:sup>\n , SHRs were 13\u201315 for DD recipients and 12\u201313 for LD recipients; at an eGFR of 30 ml\/min per 1.73 m\n 2<\/jats:sup>\n , SHRs were 5.0\u20135.7 and 5.0\u20135.5, respectively. Among first-year ICEs, acute rejection was a significant predictor of long-term graft failure in both DD (SHR=1.63,\n P<\/jats:italic>\n <0.001) and LD (SHR=1.51,\n P<\/jats:italic>\n =0.006) recipients; cardiovascular events were significant in DD (SHR=1.24,\n P<\/jats:italic>\n <0.001), whereas non-CMV infections were significant in the LD cohort (SHR=1.32,\n P<\/jats:italic>\n =0.03). Adjustment for ICEs did not significantly reduce the association of eGFR with graft failure.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Twelve-month eGFR is a strong predictor of long-term graft failure after accounting for clinical events occurring from discharge to 1 year. These findings may improve patient management and clinical evaluation of novel interventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0007342021","type":"journal-article","created":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T22:00:19Z","timestamp":1643148019000},"page":"714-727","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":26,"title":["Clinical Events and Renal Function in the First Year Predict Long-Term Kidney Transplant Survival"],"prefix":"10.34067","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5341-7286","authenticated-orcid":false,"given":"Jesse D.","family":"Schold","sequence":"first","affiliation":[{"name":"Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio"},{"name":"Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2424-7852","authenticated-orcid":false,"given":"Robert J.","family":"Nordyke","sequence":"additional","affiliation":[{"name":"Beta6 Consulting Group, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Wu","sequence":"additional","affiliation":[{"name":"Genesis Research, Hoboken, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Corvino","sequence":"additional","affiliation":[{"name":"Genesis Research, Hoboken, New Jersey"},{"name":"Department of Medicine, Division of Nephrology, Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiying","family":"Wang","sequence":"additional","affiliation":[{"name":"Genesis Research, Hoboken, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5305-9685","authenticated-orcid":false,"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4,28]]},"reference":[{"key":"B1-20250825","author":"United States Renal Data System: 2019 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. Available at https:\/\/usrds.org\/previous-adrs\/2010-2019\/. Accessed February 2, 2021"},{"key":"B2-20250825","doi-asserted-by":"crossref","first-page":"2824","DOI":"10.1111\/ajt.16463","article-title":"Long-term kidney transplant graft survival\u2014Making progress when most needed","volume":"21","author":"Poggio","year":"2021","journal-title":"Am J Transplant"},{"key":"B3-20250825","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/j.1600-6143.2010.03283.x","article-title":"Long-term renal allograft survival in the United States: A critical reappraisal","volume":"11","author":"Lamb","year":"2011","journal-title":"Am J Transplant"},{"key":"B4-20250825","doi-asserted-by":"crossref","first-page":"148","DOI":"10.5527\/wjn.v4.i2.148","article-title":"Management of patients with a failed kidney transplant: Dialysis reinitiation, immunosuppression weaning, and transplantectomy","volume":"4","author":"Pham","year":"2015","journal-title":"World J Nephrol"},{"key":"B5-20250825","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1046\/j.1523-1755.2002.00424.x","article-title":"Post transplant renal function in the first year predicts long-term kidney transplant survival","volume":"62","author":"Hariharan","year":"2002","journal-title":"Kidney Int"},{"key":"B6-20250825","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1097\/00007890-199911150-00017","article-title":"Quantitative assessment of the first acute rejection as a predictor of renal transplant outcome","volume":"68","author":"Ishikawa","year":"1999","journal-title":"Transplantation"},{"key":"B7-20250825","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/j.1432-2277.1993.tb00636.x","article-title":"Early prediction of renal allograft loss beyond one year","volume":"6","author":"Nicol","year":"1993","journal-title":"Transpl Int"},{"key":"B8-20250825","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1159\/000487714","article-title":"Renal function variability: An independent risk factor for graft loss and death following kidney transplantation","volume":"47","author":"Pilch","year":"2018","journal-title":"Am J Nephrol"},{"key":"B9-20250825","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/nep.13488","article-title":"Development and future deployment of a 5 years allograft survival model for kidney transplantation","volume":"24","author":"DuBay","year":"2019","journal-title":"Nephrology (Carlton)"},{"key":"B10-20250825","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1053\/j.ajkd.2010.06.020","article-title":"A simple tool to predict outcomes after kidney transplant","volume":"56","author":"Kasiske","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"B11-20250825","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1053\/j.ajkd.2010.10.054","article-title":"The relationship between kidney function and long-term graft survival after kidney transplant","volume":"57","author":"Kasiske","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"B12-20250825","doi-asserted-by":"crossref","first-page":"L4923","DOI":"10.1136\/bmj.l4923","article-title":"Prediction system for risk of allograft loss in patients receiving kidney transplants: International derivation and validation study","volume":"366","author":"Loupy","year":"2019","journal-title":"BMJ"},{"key":"B13-20250825","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1111\/j.1600-6143.2011.03552.x","article-title":"Living donor age and kidney transplant outcomes","volume":"11","author":"Noppakun","year":"2011","journal-title":"Am J Transplant"},{"key":"B14-20250825","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1097\/TP.0b013e31821ab993","article-title":"Associations of renal function at 1-year after kidney transplantation with subsequent return to dialysis, mortality, and healthcare costs","volume":"91","author":"Schnitzler","year":"2011","journal-title":"Transplantation"},{"key":"B15-20250825","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1432-2277.2011.01395.x","article-title":"Renal function following living, standard criteria deceased and expanded criteria deceased donor kidney transplantation: Impact on graft failure and death","volume":"25","author":"Schnitzler","year":"2012","journal-title":"Transpl Int"},{"key":"B16-20250825","doi-asserted-by":"crossref","first-page":"3440","DOI":"10.1681\/ASN.2015050524","article-title":"Relationship between eGFR decline and hard outcomes after kidney transplants","volume":"27","author":"Clayton","year":"2016","journal-title":"J Am Soc Nephrol"},{"key":"B17-20250825","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/j.1600-6143.2010.03016.x","article-title":"A phase III study of belatacept versus cyclosporine in kidney transplants from extended criteria donors (BENEFIT-EXT study)","volume":"10","author":"Durrbach","year":"2010","journal-title":"Am J Transplant"},{"key":"B18-20250825","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1056\/NEJMoa1506027","article-title":"Belatacept and long-term outcomes in kidney transplantation","volume":"374","author":"Vincenti","year":"2016","journal-title":"N Engl J Med"},{"key":"B19-20250825","doi-asserted-by":"crossref","first-page":"2562","DOI":"10.1056\/NEJMoa067411","article-title":"Reduced exposure to calcineurin inhibitors in renal transplantation","volume":"357","author":"Ekberg","year":"2007","journal-title":"N Engl J Med"},{"key":"B20-20250825","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.1111\/j.1600-6143.2012.04101.x","article-title":"Kidney function and risk of cardiovascular disease and mortality in kidney transplant recipients: The FAVORIT trial","volume":"12","author":"Weiner","year":"2012","journal-title":"Am J Transplant"},{"key":"B21-20250825","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1681\/ASN.2018111101","article-title":"Long-term outcomes after acute rejection in kidney transplant recipients: An ANZDATA analysis","volume":"30","author":"Clayton","year":"2019","journal-title":"J Am Soc Nephrol"},{"key":"B22-20250825","article-title":"KDIGO clinical practice guideline for the care of kidney transplant recipients"},{"key":"B23-20250825","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s40620-018-0549-4","article-title":"Cardiovascular risk in renal transplant recipients","volume":"32","author":"Devine","year":"2019","journal-title":"J Nephrol"},{"key":"B24-20250825","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1053\/ajkd.1998.v32.pm9820470","article-title":"Clinical epidemiology of cardiovascular disease in chronic renal disease","volume":"32","author":"Foley","year":"1998","journal-title":"Am J Kidney Dis"},{"key":"B25-20250825","doi-asserted-by":"crossref","first-page":"288","DOI":"10.2215\/CJN.00920805","article-title":"Incidence, predictors, and associated outcomes of atrial fibrillation after kidney transplantation","volume":"1","author":"Lentine","year":"2006","journal-title":"Clin J Am Soc Nephrol"},{"key":"B26-20250825","doi-asserted-by":"crossref","first-page":"2887","DOI":"10.1681\/ASN.2020050566","article-title":"Death after kidney transplantation: An analysis by era and time post transplant","volume":"31","author":"Ying","year":"2020","journal-title":"J Am Soc Nephrol"},{"key":"B28-20250825","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/ajt.15102","article-title":"Lymphocyte depletion and risk of acute rejection in renal transplant recipients at increased risk for delayed graft function","volume":"19","author":"Ravindra","year":"2019","journal-title":"Am J Transplant"},{"key":"B29-20250825","doi-asserted-by":"crossref","first-page":"763","DOI":"10.2215\/CJN.10860917","article-title":"HLA-DQ mismatching and kidney transplant outcomes","volume":"13","author":"Leeaphorn","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B30-20250825","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"B31-20250825","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"key":"B33-20250825","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New creatinine- and cystatin C-based equations to estimate GFR without race","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med"},{"key":"B34-20250825","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1056\/NEJMoa2103753","article-title":"Race, genetic ancestry, and estimating kidney function in CKD","volume":"385","author":"Hsu","year":"2021","journal-title":"N Engl J Med"},{"key":"B35-20250825","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1056\/NEJMra2014530","article-title":"Long-term survival after kidney transplantation","volume":"385","author":"Hariharan","year":"2021","journal-title":"N Engl J Med"}],"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0007342021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:01:31Z","timestamp":1786478491000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0007342021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,28]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.34067\/kid.0007342021","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,28]]},"assertion":[{"value":"2021-11-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}