Supplemental Material for: Kidney transplantation outcomes in older adults: the influence of comorbidity burden

Cross-referencing clinical data from the Renal Epidemiology and Information Network (REIN) registry and healthcare utilization data from the French National Health Data (SNDS) database allowed identifying all ≥65-year-old patients who started kidney replacement therapy in France between January 1, 2017 and December 31, 2018, and who underwent a first kidney transplantation before December 31, 2020 (n = 749). Follow-up was to December 31, 2021.

Cox proportional hazards models were used to analyze survival, and multilevel logistic regression models to evaluate hospitalization outcomes.</p><p dir="ltr">Results: In the ≥65-year-old patients identified (n = 749), age group did not have an independent effect on 1-year survival rate. Conversely, age was correlated with longer initial hospitalization (OR = 2.15, 95% CI [1.3-3.5]) and longer cumulative hospital stay during the first year post-transplant (OR = 2.04, 95% CI [1.2-3.3]).

Peripheral artery disease was associated with a nearly 2-fold increased risk of death during the first year following kidney transplantation (HR=1.97, 95% CI [1.02-3.82]).</p><p dir="ltr">Conclusion: While peripheral artery disease was associated with reduced 1-year survival after kidney transplantation, no significant association was found between age group and mortality; however, a trend toward lower survival was observed in recipients aged >75 years.

In addition, older age was associated with prolonged initial hospitalization and rehospitalization in the first post-transplant year, potentially impacting quality of life.</p>