The utility of screening colonoscopy during kidney transplant evaluation

Yu Zheng, Kevin V. Chaung, Paul J. Park, Joshua J. Augustine, Nagaraju Sarabu, James A. Schulak, Edmund Q. Sanchez, Vanessa R. Humphreville, John B. Ammori, Kenneth J. Woodside

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: Transplant centers often recommend, but not necessarily require, screening colonoscopies for people over 50 years of age in accordance with the US Preventative Services Task Force guidelines for the general population. We sought to identify risk factors affecting colonoscopy results in renal failure patients undergoing kidney transplant evaluation. Materials and Methods: We retrospectively examined patients undergoing kidney transplant evaluation from 2009 to 2012 (n = 469 patients). Comparisons were made between colonoscopy reports categorized as normal (no finding or hyperplastic polyp) or abnormal (adenomatous polyp or carcinoma). Results: Of 469 patients who met the study criteria, 303 (64.6%) had normal colonoscopies and 166 (35.4%) had abnormal colonoscopies. Logistic regression analysis showed that male sex (odds ratio = 2.09; 95% confidence interval, 1.37-3.20; P = .001) and increasing age (odds ratio = 1.04; 95% confidence interval, 1.01-1.08; P = .019) were more likely to correspond to abnormal findings. Those with dialysis vintage (length of time on dialysis) up to 3 years (odds ratio = 2.10; 95% confidence interval, 1.09-4.06; P = .027) and hypertension as the cause of renal failure (odds ratio = 1.79; 95% confidence interval, 1.05-2.87; P = .002) had more abnormal findings. No differences in length of evaluation, rate of being listed for transplant, and rate of transplant were shown. Conclusions: The overall rate of adenomatous findings on colonoscopy was higher among patients with pretransplant end-stage renal disease than in the general population, as shown in other studies. Age, sex, dialysis vintage up to 3 years, and hypertensive renal failure were associated with adenomatous polyps of the colon in this study population. Because adenomatous polyp rates are high in patients with chronic kidney disease who are undergoing transplant evaluation and colonoscopic findings do not appear to delay transplant evaluations or listing rates, screening colonoscopies should be encouraged.

Original languageEnglish (US)
Pages (from-to)602-608
Number of pages7
JournalExperimental and Clinical Transplantation
Volume15
Issue number6
DOIs
StatePublished - Dec 2017
Externally publishedYes

Bibliographical note

Funding Information:
From the 1Division of Transplant Surgery, Department of Surgery, the 2Division of Nephrology, Department of Internal Medicine, and the 3Division of General and Oncologic Surgery, Department of Surgery, Case Western Reserve University and University Hospitals, Case Medical Center, Cleveland, Ohio, USA; and the 4Section of Transplantation Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA Acknowledgements: None of the authors have conflicts of interest to report. This study was made possible through support from the Office of Medical Education and Committee of Student Representatives at Case Western Reserve University School of Medicine, as well as the Case Western Reserve University School of Graduate Studies. The authors thank Kelly Noon and Genevieve Popp for database assistance. Corresponding author: Kenneth J. Woodside, Section of Transplant Surgery, Department of Surgery, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5300, USA

Publisher Copyright:
© Başkent University 2017.

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • Cancer screening
  • Chronic kidney disease
  • Colon cancer
  • Colorectal cancer
  • End-stage renal disease
  • Renal transplant

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