Immunosuppressant nonadherence profile in kidney transplant recipients and the impact of medication adherence on transplant outcomes

2024

Understanding Medication Nonadherence in Kidney Transplant Recipients

Sample size: 409 publication 10 minutes Evidence: moderate

Author Information

Author(s): Zhi-yu Zou, Lin-rui Dai, Chen-zhen Yu, Ren-jie Chen, Fei-hong Yu, Song Chen, Sheng Chang, Wei-jie Zhang

Primary Institution: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Hypothesis

What are the correlates and impacts of immunosuppressant nonadherence on kidney transplant outcomes?

Conclusion

Immunosuppressant nonadherence is common among kidney transplant recipients and is linked to worse graft outcomes.

Supporting Evidence

The prevalence of nonadherence to immunosuppressant therapy was found to be 41.6%.
Longer time post-transplant was positively correlated with nonadherence.
Recipients on twice-daily immunosuppressive regimens had a significantly higher risk of nonadherence.
Renal function remained stable in adherent recipients but declined in nonadherent recipients.
The incidence of graft loss was significantly higher in the nonadherent group (7.1% vs. 1.7%).
The incidence of rejection was also higher in the nonadherent group (12.4% vs. 4.2%).
Medication adherence was assessed using the BAASIS questionnaire, which is validated for this population.

Takeaway

Many kidney transplant patients forget to take their medicine, which can lead to serious problems with their new kidney.

Methodology

A questionnaire survey was conducted on 431 renal transplant recipients, with 409 valid responses analyzed for adherence and clinical outcomes over one year.