Comparing emergency admissions and outcomes of preemptive and non-preemptive renal transplant recipients: a comprehensive analysis

Background Renal transplantation (RTx) is the most effective treatment for end-stage renal disease (ESRD), enhancing both patient and graft survival. The timing of transplantation—preemptive (before dialysis) or non-preemptive (after dialysis)—may influence long-term outcomes. This study aims to compare emergency internal medicine admissions and clinical outcomes between pRTx and npRTx recipients. Materials and methods Renal transplant patients who presented to the Emergency Internal Medicine Unit of Istanbul Faculty of Medicine between January 1, 2020, and March 1, 2021, were categorized into two groups: preemptive (pRTx) and non-preemptive (npRTx). Data on presenting complaints, demographic characteristics, medical history, comorbidities, laboratory findings, survival rates, and post-transplant complications were evaluated. Results A total of 295 patients were included in our study, of which 261 (88.5%) were renal transplant patients followed at our center, and 34 (11.5%) were followed at external centers. The patients had a mean age of 45.8 + 13.3 years, and 140 patients (47.5%) were female. RTx was performed from a living donor in 227 patients (76.9%), while 68 patients (23.1%) received a transplant from a cadaveric donor. 70 patients (23.7%) were in the pRTx group, while 225 patients (76.3%) were in the npRTx group. The frequency of comorbidities such as hypertension and diabetes mellitus was significantly higher in the npRTx group compared to the pRTx group. The rate of outpatient treatment was considerably higher in the pRTx; while shortness of breath, chest pain, and hospitalization rates were observed to be higher in the npRTx. There was no difference observed in terms of intensive care unit admission, intubation, and mortality between the two groups. Conclusion It was remarkable that the npRTx group had a higher prevalence of comorbid diseases, hospitalization rates, and infection profiles. However, there is no difference in mortality between the two groups with sufficient renal protection and treatment adherence. Trial registration: This study was registered retrospectively in an appropriate clinical trial registry.