Bayesian analysis of glomerular filtration rate trajectories in kidney transplant recipients: a pilot study

2.50
Hdl Handle:
http://hdl.handle.net/11287/593936
Title:
Bayesian analysis of glomerular filtration rate trajectories in kidney transplant recipients: a pilot study
Authors:
Ferro, C. J.; Hodson, J.; Moore, Jason; McClure, M.; Tomson, C. R.; Nightingale, P.; Borrows, R.
Abstract:
BACKGROUND: Detailed modeling and analysis of renal (dys)function trajectories has not been undertaken in kidney transplant recipients. Although previous studies have assumed linear trajectories, this likely represents an oversimplification. METHODS: In this study, a Bayesian smoothing technique was undertaken to create 10,000 Monte Carlo samples for each of 158 patients over a median of 88 months. Specific parameters investigated were the prevalence of nonlinear trajectories, periods of nonprogression, and of rapid progression. RESULTS: Forty-five (28%) patients displayed high probability (>80%) for a nonlinear trajectory. Periods of nonprogression were also common, present in 110 (70%) patients. A substantial proportion of patients showed deviation from the classic paradigm of progressive linear loss of graft function with 137 (87%) patients displaying nonlinearity or nonprogression. Only nine (6%) patients demonstrated at least one episode of nonprogression after an episode of progression, that is, once progression occurred, a subsequent period of nonprogression was uncommon. Episodes of nonprogression were less common (P < 0.001) in patients whose grafts subsequently failed, whereas episodes of rapid progression were more common (P = 0.04). CONCLUSION: This study highlights the often nonlinear and nonprogressive nature of renal function decline after transplantation. Heightened understanding of the factors influencing these trajectories should help inform patients and clinicians alike.
Citation:
Transplantation. 2015 Mar;99(3):533-9.
Publisher:
Transplantation
Journal:
Transplantation
Issue Date:
1-Mar-2015
URI:
http://hdl.handle.net/11287/593936
DOI:
10.1097/TP.0000000000000377
PubMed ID:
25386706
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/25386706
Type:
Journal Article; Research Support, Non-U.S. Gov't
Language:
eng
ISSN:
1534-6080
Appears in Collections:
2015 RD&E publications; Exeter Kidney Unit (Renal)

Full metadata record

DC FieldValue Language
dc.contributor.authorFerro, C. J.en
dc.contributor.authorHodson, J.en
dc.contributor.authorMoore, Jasonen
dc.contributor.authorMcClure, M.en
dc.contributor.authorTomson, C. R.en
dc.contributor.authorNightingale, P.en
dc.contributor.authorBorrows, R.en
dc.date.accessioned2016-01-19T12:37:36Zen
dc.date.available2016-01-19T12:37:36Zen
dc.date.issued2015-03-01en
dc.identifier.citationTransplantation. 2015 Mar;99(3):533-9.en
dc.identifier.issn1534-6080en
dc.identifier.pmid25386706en
dc.identifier.doi10.1097/TP.0000000000000377en
dc.identifier.urihttp://hdl.handle.net/11287/593936en
dc.description.abstractBACKGROUND: Detailed modeling and analysis of renal (dys)function trajectories has not been undertaken in kidney transplant recipients. Although previous studies have assumed linear trajectories, this likely represents an oversimplification. METHODS: In this study, a Bayesian smoothing technique was undertaken to create 10,000 Monte Carlo samples for each of 158 patients over a median of 88 months. Specific parameters investigated were the prevalence of nonlinear trajectories, periods of nonprogression, and of rapid progression. RESULTS: Forty-five (28%) patients displayed high probability (>80%) for a nonlinear trajectory. Periods of nonprogression were also common, present in 110 (70%) patients. A substantial proportion of patients showed deviation from the classic paradigm of progressive linear loss of graft function with 137 (87%) patients displaying nonlinearity or nonprogression. Only nine (6%) patients demonstrated at least one episode of nonprogression after an episode of progression, that is, once progression occurred, a subsequent period of nonprogression was uncommon. Episodes of nonprogression were less common (P < 0.001) in patients whose grafts subsequently failed, whereas episodes of rapid progression were more common (P = 0.04). CONCLUSION: This study highlights the often nonlinear and nonprogressive nature of renal function decline after transplantation. Heightened understanding of the factors influencing these trajectories should help inform patients and clinicians alike.en
dc.language.isoengen
dc.publisherTransplantationen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/25386706en
dc.titleBayesian analysis of glomerular filtration rate trajectories in kidney transplant recipients: a pilot studyen
dc.typeJournal Articleen
dc.typeResearch Support, Non-U.S. Gov'ten
dc.identifier.journalTransplantationen

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