Prospective Study on Late Consequences of Subclinical Non-Compliance with Immunosuppressive Therapy in Renal Transplant Patients
Version of Record online: 12 AUG 2004
American Journal of Transplantation
Volume 4, Issue 9, pages 1509–1513, September 2004
How to Cite
Vlaminck, H., Maes, B., Evers, G., Verbeke, G., Lerut, E., Van Damme, B. and Vanrenterghem, Y. (2004), Prospective Study on Late Consequences of Subclinical Non-Compliance with Immunosuppressive Therapy in Renal Transplant Patients. American Journal of Transplantation, 4: 1509–1513. doi: 10.1111/j.1600-6143.2004.00537.x
- Issue online: 12 AUG 2004
- Version of Record online: 12 AUG 2004
- Received 26 December 2004, revised and accepted for publication 29 April 2004
- Late acute rejection;
- renal transplantation
In this prospective study we compared the incidence of late acute rejections (LAR) and changes in serum-creatinine over time between compliers and noncompliers with immunosuppressive therapy more than 1 year post transplantation and explored the relative contribution of non-compliance and other risk factors in the occurrence of LAR.
One hundred and forty-six adult renal transplant recipients were followed during a 5-year period. Patients were interviewed at the beginning of the study and categorized as non-compliers if they admitted to have skipped immunosuppressive medication on a regular basis during the previous 12 months. The occurrence of LAR during the follow-up period was recorded.
We identified 22.6% non-compliers of which 21.2% experienced a late acute rejection compared with 8% in the group of compliers at 5 years postinclusion (p < 0.05). Kaplan-Meier survival analysis showed a decreased rejection free time in non-compliers compared with compliers (p = 0.03). Non-compliant patients had a 3.2 higher risk of LAR (Cox regression analysis, p = 0.005). Non-compliers experienced a higher increase in serum-creatinine over time (Linear Mixed Models, p < 0.001).
Non-compliance in renal transplant patients more than 1-year post transplantation is associated with an increased risk for LAR and a higher increase in serum-creatinine during the following 5 years.