Kidney Week

Abstract: SA-PO952

Comparisons of Mortality, Wait-Listing, and Transplantation Outcomes of Young Adults in the United States Renal Data System (USRDS)

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Parulekar, Jaya S., Indiana University School of Medicine, Indianapolis, Indiana, United States

Jaya S. Parulekar, MD

• Laster, Marciana, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, United States

Marciana Laster, MD, MS

• Pottanat, Neha D., Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, United States

Neha D. Pottanat, MD

• Di, Mengyu, Regenstrief Institute, Indianapolis, Indiana, United States

Mengyu Di, MS

• Buford, Jade, Regenstrief Institute, Indianapolis, Indiana, United States

Jade Buford, MPH

• Patzer, Rachel E., Regenstrief Institute, Indianapolis, Indiana, United States

Rachel E. Patzer, PhD, MPH

Background

Young adults are a unique patient population, with the highest incidence of end-stage kidney disease (ESKD) among pediatric subgroups. Despite differences in ESKD cause, comorbidities, and social factors between younger and older adults, young adults are placed in a composite adult category of 18-44 years. Our goal is to better characterize young adults with ESKD (ages 18-25) and compare outcomes with those of older adults (ages 26-44).

Methods

Using data from USRDS, we identified 87,411 incident dialysis patients aged 18-44 starting dialysis from 2015-2020, 9.5% aged 18-25 years and 90.5% aged 26-44 years, following to 2021 for waitlisting and transplant. Multivariable Cox proportional hazards models studied time to mortality, waitlisting, and transplant by age, adjusting for demographics, ESKD cause, comorbidities, pre-ESKD care, transplant awareness, insurance, neighborhood and dialysis-facility variables.

Results

Glomerulonephritis (43%) was the most common cause of ESKD in young adults vs. diabetes (40%) in older adults (Table 1). More older adults had hypertension (86% vs. 76%) and obesity (27% vs. 15%). Younger adults had a 29% lower mortality risk and higher likelihood of waitlisting (33%), transplantation among dialysis-started (32%), and transplantation among waitlisted (18%) (Table 2).

Conclusion

Our analysis provides initial insights into characterizing the broad adult group aged 18-44. Younger adults showed decreased mortality and better transplant outcomes. Future research is needed to define critical age groups with notable outcome differences.

Funding

• NIDDK Support