Hospitalization Causes in Kidney Transplant Recipients: A Cross-Sectional Study from Isfahan, Iran

Abstract

Introduction. Kidney transplantation significantly improves survival and quality of life in End-Stage Kidney Disease (ESKD). However, kidney transplant recipients (KTRs) are prone to complications leading to hospitalization. Data on hospitalization etiologies among Iranian KTRs remain limited. Methods. This cross-sectional study included all KTRs hospitalized in the two centers with kidney transplant department in Isfahan between March 2023 and March 2024. Demographic, clinical, and laboratory data were collected from medical records. Etiologies of admission were classified, and descriptive and analytical statistics were calculated using SPSS, version 22. Results. A total of 408 patients (60.7 male, mean age 45.6 +/- 15.2 years) were included. The most frequent comorbidities were diabetes mellitus (DM) (27.2) and hypertension (HTN) (22.2). Most patients (42.5) had undergone transplantation for more than 10 years. The leading causes of admission were constitutional symptoms including fever, myalgia, and fatigue in 165 (40.4), azotemia in 55 (13.5), dysuria in 23 (5.6) and limb edema in 21 (5.1) patients. The main final diagnosis in hospitalized KTRs were infections (42.5) and acute kidney injury (AKI)/AKI superimposed on chronic kidney disease (CKD) (15.6). Laboratory findings revealed a mean serum creatinine of 2.58 +/- 2.16 mg/dL, with 50 above 1.7 mg/dL. Anemia (Hb < 10 g/dL) was present in 43.7 of cases. Urinalysis showed hematuria in 50.3 and pyuria in 64.2 of patients. Graft failure requiring dialysis occurred in 9 (2.2) patients. Eighteen (4.4) patients died during hospitalization period. Conclusion. Infections and acute kidney injury (AKI) were the predominant causes of hospitalization among Isfahan KTR population.