Publication Spotlight: Dr. Garcia

Interview with Leonardo Pozo Garcia, MD, Baylor College of Medicine, author of Dialysis Modality, Transplant Characteristics, and Incident Atrial Fibrillation After Kidney Transplant: An Observational Study Using USRDS Data.

What question did your study aim to answer?

Our study aimed to determine whether pretransplant dialysis modality, specifically hemodialysis versus peritoneal dialysis, was associated with risk of posttransplant atrial fibrillation.

What inspired you to conduct this study?

Atrial fibrillation confers a substantial risk of stroke, morbidity and mortality. The prevalence of atrial fibrillation is higher in patients with end-stage kidney disease as compared to the general population. It occurs more frequently in patients on hemodialysis as compared to patients on peritoneal dialysis, occurring in as many as 1 of 3 individuals on hemodialysis. Even after patients receive kidney transplants, atrial fibrillation continues to occur in up to 7% of kidney transplant recipients. We were interested in studying whether pretransplant dialysis modality is associated with the risk of atrial fibrillation posttransplantation.

Which USRDS datasets did you use to conduct your study?

We used the USRDS standard analytical files, which includes Core file (eg: patients, medevid, rxhist, etc,.), Transplant file, Institutional Claims, Medicare Claims, and Physician Supplier files.

Using plain language, please summarize your study conclusions in two or three points.

• We found that patients who received hemodialysis as compared to those who received peritoneal dialysis pretransplantation were at 20% increased risk of developing new onset atrial fibrillation posttransplantation.
• We also found that other factors such as longer dialysis vintage, female donor, and having a high number of HLA mismatches were also associated with a higher risk of atrial fibrillation posttransplantation.
• As we learn more about risk factors for posttransplant atrial fibrillation, we can more accurately stratify patients into risk categories allowing us to monitor and manage high- risk patients.

Please share a specific insight about working with USRDS data that you learned during the completion of this study.

We did not gain any new insight from conducting this specific study. We are very familiar with the wealth of data in the USRDS database and have used it for a multitude of studies that we have previously published.