Individuals who receive a solid organ transplant in the United States are followed up annually for assessment of their health status. These data are recorded in the Scientific Registry of Transplant Recipients (SRTR). All analyses presented are limited to adults aged 20 years or older at the time of their first organ transplant. These data are nationally-representative of the first-time, solid-organ transplant population with less than 5% lacking information on kidney function.

Individuals who receive a solid organ transplant in the United States are followed up annually on the anniversary of the transplant date for an assessment of their health status. These data are recorded in the Scientific Registry of Transplant Recipients (SRTR). All analyses presented are limited to adults 20 years or older at the time of their first organ transplant. Diabetes status (type 1 or 2) and hypertension status are as listed at the time of transplant. For all transplant recipients, use of calcineurin inhibitors (CNI) to prevent transplant rejection is presented as many of these medications have been shown to be nephrotoxic (see Ojo, 2007, for a review). The recording of data in the SRTR pertaining to CKD/kidney function varies by organ type and is discussed below.

Thoracic transplant (heart, lung and combined heart and lung) recipients do not have a serum creatinine measurement reported but rather a yes/no “renal dysfunction” indicator at follow-up. Information on treatment for ESRD (through dialysis or kidney transplant) is provided for thoracic transplant recipients (all patients treated for ESRD are necessarily indicated to have “renal dysfunction,” but an individual with “renal dysfunction” may or may not have been treated for ESRD). A thoracic transplant patient is defined as having “renal dysfunction” if the patient was reported as such. We have therefore retained the terminology “renal dysfunction” as opposed to “CKD” for this section of the chapter.