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Clin Transplant. 2019 Jun;33(6):e13565. doi: 10.1111/ctr.13565. Epub 2019 May 7.

Substance use in kidney transplant candidates and its impact on access to kidney transplantation.

Author information

1
Division of Nephrology, Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada.
2
Center for Translational & Clinical Research Aachen (CTC-A), Uniklinik RWTH Aachen University, Aachen, Germany.
3
Centre for Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
4
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Due to the increasing public acceptance of substance use, it is important to understand the association between substance use and access to kidney transplant and its outcomes. Here, we assess the sociodemographic predictors of substance use and the association between substance use and KT access.

METHODS:

Predictors of substance use were examined using a multivariable-adjusted multinomial logistic regression. The association between current substance use (tobacco and drug) and time from referral to listing or receipt of a KT was examined using Cox proportional hazards models.

RESULTS:

Of 2346 patients, the prevalence of current substance use was 17%. Predictors of current tobacco use were younger age, male sex, Caucasian ethnicity, being unemployed, and unmarried. Predictors of current drug use were younger age, male sex, Caucasian ethnicity, a history of non-adherence, and a history of mental health disorder. Patients with tobacco use had a decreased likelihood of being cleared for KT (hazard ratio [HR]:0.83[0.70, 0.99]) and receiving a KT (HR:0.80 [0.66, 0.96]). No association was seen in this sample for patients with drug use (HR:0.88 [0.69, 1.11] for being cleared for KT and 0.88 [0.69, 1.14] for KT, respectively).

CONCLUSIONS:

Tobacco use was associated with a decreased likelihood of access to KT whereas there was no statistically significant difference in access to KT between patients with or without drug use.

KEYWORDS:

drug; kidney transplant; substance use; tobacco

PMID:
31002182
DOI:
10.1111/ctr.13565

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