#3562 Bridging the gap: the effect of proximity on transplant care in a remote island community

Abstract Background and Aims Fuerteventura is one of the largest islands in terms of surface area in the Canary Island; however, it is not one of the most populated. Since 2020, the island's population has increased considerably, requiring an expansion of available healthcare services. In 2022, with the aim of improving the quality of life of renal patients, a kidney transplant follow-up clinic was established to operate alternately with the referral hospital. This study evaluates the effectiveness of this clinic and the clinical advantages of having a nephrologist accessible most of the time. The follow-up protocol consists of consultations every 2–3 months at the regional hospital and once a year at the referral hospital. Method A cross-sectional study was conducted with 42 kidney transplant recipients, who were followed up jointly between the clinic at Hospital Virgen de la Peña (Fuerteventura) and Hospital Insular Materno Infantile (Gran Canaria). The estimated glomerular filtration rate, the albumin/creatinine ratio, total proteinuria in 24-hour urine, and the number of emergency hospital admissions per patient were compared over two periods: before the establishment of the transplant clinic (2020–2022) and after its implementation (2022–2024). Additionally, population characteristics and comorbidities were evaluated, and the data were analyzed using SPSS v25. Results Currently, there are 42 kidney transplant patients on the island, with a mean age of 55.4 ± 13.1 years, of whom 11.9% (N = 5) have undergone a second transplant. The primary cause of kidney disease was, in order of frequency, of unidentified etiology (23.8%) and focal segmental glomerulosclerosis (16.7%). Significant differences were found in the reduction of the number of urgent hospital admissions, from 0.83 ± 1.2 admissions between 2020–2022 to 0.40 ± 0.734 admissions between 2022–2024. Differences were also observed in 24-hour proteinuria, with values of 409.85 ± 412 mg/24 h and 356 ± 528 mg/24 h, respectively. Conclusion These results highlight the impact of having a kidney transplant clinic closer to patients, improving proteinuria, thereby enhancing the longevity of renal grafts and reducing urgent complications. This, in turn, leads to an improved quality of life for transplant patients. Additionally, the reduction in hospital costs allows for the implementation of new diagnostic and therapeutic techniques.