Incidence of Malignancy and Risk Factors Associated with Kidney Transplant Patients

Background: The incidence and risk factors associated with the development of post-transplant malignancies contributes to increased morbidity among kidney transplant recipients were examined in this study. Materials and Methods: A retrospective cross-sectional analysis was conducted to evaluate the medical records of all kidney transplant recipients at Urmia Imam Khomeini Hospital from January 2000 to December 2020. Patients were stratified into two groups based on the presence or absence of post-transplant malignancy. Demographic data, comorbidities, cancer history, and immunosuppression regimens were collected and compared between the groups. Statistical significance was determined using appropriate tests. All analyses were performed using SPSS 21, and a P-value of less than 0.05 was considered statistically significant. Results: Of the 4070 kidney transplant recipients, 3042 (74.7%) were male and 1028 (25.3%) were female. The mean age at malignancy diagnosis was 53.78 years (standard deviation ± 14.24). The overall incidence of post-transplant malignancy was 9.6% per 1,000 patients (95% confidence interval: 9.6-13.2). Incidence rates varied significantly by age group: 4.6% for those younger than 30, 7.6% for those aged 30-50, and 29.3% for those older than 50 (P<0.001). A small percentage of patients (n=3, 7.7%) required the addition of antithymocyte globulin (ATG) to their primary immunosuppression regimen. The most commonly used immunosuppressive regimens were prednisolone in combination with either sandimune and azathioprine or sandimune and cellcept, employed in 35.9% of patients. The most common underlying causes of kidney failure were glomerulonephritis (GN) and hypertension (HTN), accounting for 38.5% and 35.9% of cases, respectively. Conclusion: Kidney transplant recipients demonstrated a higher incidence of post-transplant malignancies. Male sex, older recipient age, and a history of underlying diseases were identified as significant risk factors for malignancy development. The primary cause of kidney failure among the patients was GN, followed by HTN.