1. CHAPTER 5 RENAL TRANSPLANTATION Editor: Dr. Goh Bak Leong Expert Panel: Dato’ Dr. Zaki Morad b Mohd Zaher (Chair) Dr. Goh Bak Leong (Co-Chair) Dr. Fan Kin Sing Dr. Lily Mushahar Mr. Rohan Malek Dr. S. Prasad Menon Prof. Dr. Tan Si Yen

2. Table 5.1.1: Stock and Flow of Renal Transplantation, 1999-2008 Year1999200020012002200320042005200620072008 New transplant patients12714316317216019016214110088 Died25303733374243503948 Graft failure37324039424421383732 Lost to Follow up193541410 1810 Functioning graft at 31 st December 1178125013331428150515951683172617321730

3. Figure 5.1.1: Stock and Flow of Renal Transplantation, 1975-2008

4. Table 5.1.2: New transplant rate per million population (pmp), 1999-2008 Year1999200020012002200320042005200620072008 New transplant patients12714316317216019016214110088 New transplant rate, pmp 6677676543 Figure 5.1.2: New transplant rate, 1975-2008 New Transplant rate, pmp Year 0 1 2 3 4 5 6 7 8 9 10 Rate, pmp 7577798183858789919395979901030507

5. Table 5.1.3: Transplant prevalence rate per million population (pmp), 1999-2008 Year1999200020012002200320042005200620072008 Functioning graft at 31 st Dec1178125013331428150515951683172617321730 Transplant prevalence rate, pmp 52535658606264656462 Figure 5.1.3: Transplant prevalence rate, 1975-2008

6. Table 5.1.4: Place of transplantation, 1999-2008 Year 19992000200120022003 No.% % % % % HKL3628 20332030172616 UMMC16131913231415964 Selayang Hospital0043117 6 7 Other local1132421111 China6350805683511036011169 India54968512743 Other overseas2200110011 Unknown4300000000 TOTAL127100143100163100172100160100 Year 20042005200620072008TOTAL No.% % % % % % HKL20113119352536 323630721 UMMC7474540000987 Selayang Hospital116539614 78836 Other local2153213378292 China1377210867815741 4784859 India11653751111634 Other overseas2111215500141 Unknown000000000040 TOTAL190100162100141100 881001446100

7. Table 5.2.1: Renal Transplant Recipients’ Characteristics, 1999-2008 Year1999200020012002200320042005200620072008 New Transplant Patients12714316317216019016214110088 Age at transplant (years), Mean373941 424138373634 Age at transplant (years), SD131413 14151615 % Male62646358666270676358 % Diabetic (co-morbid/ primary renal disease) 1115181522 20211415 % HBsAg positive4557854754 % Anti-HCV positive11815810828 4

8. Table 5.2.2: Primary causes of end stage renal failure, 1999-2008 Year 19992000200120022003 No.% % % % % New transplant patients127100143100163100172100160100 Glomerulonephritis41325035442754315434 Diabetes Mellitus108161123141692616 Hypertension762014171024142516 Obstructive uropathy4332322121 ADPKD1132113253 Drugs/ toxic nephropathy0000000021 Hereditary nephritis0000000000 Unknown62495438613770415836 Others651282314169128 Year 20042005200620072008 No.% % % % % New transplant patients190100162100141100 88100 Glomerulonephritis62334427523729 2124 Diabetes Mellitus321729182216991011 Hypertension51273924312224 1517 Obstructive uropathy4232431100 ADPKD5332111100 Drugs/ toxic nephropathy2100110022 Hereditary nephritis1100000000 Unknown83445031443137 4045 Others27141710161114 1214

9. Table 5.3.1: Type of Renal Transplantation, 1999-2008 Year 19992000200120022003 No.% % % % % Commercial cadaver6452805683511036011270 Commercial live donor43967411632 Live donor (genetically related) 40332115322033192516 Live donor (emotionally related) 5464423253 Cadaver108271937232213159 Total123100143100163100172100160100 Year 20042005200620072008 No.% % % % % Commercial cadaver1437610565825841 4045 Commercial live donor6385542211 Live donor (genetically related) 21113723241720 2225 Live donor (emotionally related) 213143111234 Cadaver17996261825 2225 Total1891001621001411009910088100 *Commercial Cadaver (China, India, other oversea) *Commercial live donor (living unrelated) *Cadaver (local)

10. Biochemical parameters Summary200620072008 Creatinine, umol/LN159216861499 Mean135.7131.8131 SD81.377.680.2 Median120116113 Minimum21.73629 Maximum115211861181 Hb, g/dLN159216861499 Mean12.712.812.9 SD1.9 Median12.8 12.9 Minimum3.34.46.2 Maximum19.818.718.6 Albumin, g/LN159216861499 Mean40 SD0.70.8 Median40 Minimum29 30 Maximum48 50 Calcium, mmol/LN159216861499 Mean2.3 SD0.2 Median2.3 Minimum1.11.41 Maximum3.13.23.5 Biochemical parameters Summary200620072008 Phosphate, mmol/LN159216861499 Mean1.1 SD0.20.3 Median1.1 Minimum0.5 Maximum3.53.93.2 Alkaline Phosphate (ALP), U/L N159216861499 Mean79.179.478.4 SD43.239.847.9 Median717270 Minimum242220 Maximum700508985 ALT, U/LN159216861499 Mean29.8 28.6 SD30.425.731 Median222322 Minimum444 Maximum433356733 Total cholesterol, mmol/L N159216861499 Mean5.35.2 SD111 Median5.3 Minimum1.51.72 Maximum11.111.411.2 Table 5.3.2: Biochemical data, 2006-2008

11. Biochemical parametersSummary200620072008 LDL cholesterol, mmol/LN159216861499 Mean332.9 SD0.8 Median333 Minimum110.9 Maximum11.18.97.7 HDL cholesterol, mmol/LN159216861499 Mean1.61.51.6 SD0.50.40.5 Median1.6 Minimum0.4 0.5 Maximum5.87.5 Systolic Blood Pressure, mmHg N159216861499 Mean130.7131.6129.4 SD15.915.716.1 Median130 Minimum6680 Maximum210 245 Diastolic Blood Pressure, mmHg N159216861499 Mean78.978.877.5 SD9.89.49.7 Median80 Minimum3020 Maximum120116133 Table 5.3.2: Biochemical data, 2006-2008

12. Table 5.3.3: Medication data, 2006-2008 Medication data Single drug treatmentCombined drug treatment 200620072008200620072008 N%N%N%N%N%N% All148210016641001359100148210016641001359100 (i) Immunosuppressive drug(s) treatment Prednisolone819160144497161097132197 Azathioprine000000497344792937428 Cyclosporin A50802011197611907293869 Tacrolimus (FK506)004030254173482132724 Mycophenolate Mofetil (MMF) 001020708489065472153 Rapamycin00001070332302 Others0000001814010 (ii) Non-Immunosuppressive drug(s) treatment Beta blocker775905876597407354460945 Calcium channel blocker199131841113710787539045468050 ACE inhibitor393382292292203842328221 AIIRB272181171141102101313710 Anti-lipid15611956876679467314461645 Other anti-hypertensive1116024215911140818814

13. Table 5.4.1: Post-transplant complications, 2006-2008 Post transplant complications Complication developed before transplant (regardless of complication after transplantation) Complication developed only after transplantation 200620072008200620072008 No.% % % % % % All patients159210016861001499100159210016861001499100 Diabetes (either as Primary Renal Disease or co-morbid) 21614230142041412581127 7 Cancer203020201211262 Cardiovascular disease + cerebrovascular disorder 735724614453543705 Hypertension10356510626392762354224502740027 *Hypertension: BP systolic>140 and BP diastolic >90 OR have either Beta blocker/ Calcium channel blocker / ACE inhibitor / AIIRB / Other anti-hypertensive

14. Table 5.4.2: Transplant Patients Death Rate and Graft Loss, 1999-2008 Year1999200020012002200320042005200620072008 No. at risk1145121312911380146615491638170417281730 Transplant death25303733374243503948 Transplant death rate %2232333323 Graft loss37324039424421383732 Graft loss rate %3333331222 Acute rejection00003191418120 Acute rejection rate %0000011110 All losses62 7772798664887680 All losses rate %5565564545 *Graft loss=graft failure *All losses=death / graft loss (acute rejection happens concurrently with graft failure / death)

15. Figure 5.4.2(a): Transplant Recipient Death Rate, 1976-2008 Figure 5.4.2(b): Transplant Recipient Graft Loss Rate, 1976-2008 Death rate % Year 0 10 20 30 40 50 Annual death rate 77798183858789919395979901030507 Graft loss rate % Year 0 2 4 6 8 10 12 14 16 18 Annual graft loss rate 77798183858789919395979901030507

16. Table 5.4.3: Causes of Death in Transplant Recipients, 1999-2008 Year 19992000200120022003 No.% % % % % Cardiovascular4131029716515923 Died at home61913512515513 Infection7231235204710301128 Graft failure0026000000 Cancer31026614412615 Liver disease31013123925 Accidental death1313121300 Others516392539513 Unknown2626122625 TOTAL3110034100431003310040100 Year 20042005200620072008 No.% % % % % Cardiovascular495111018716713 Died at home6135117135111223 Infection11242250224015341426 Graft failure3700004912 Cancer817511476141019 Liver disease3737590000 Accidental death0000000000 Others1022374737815 Unknown1212354912 TOTAL4610044100551004410053100

17. Table 5.4.4: Causes of Graft Failure, 1999-2008 Year 19992000200120022003 No.% % % % % Rejection23621959256123562147 Calcineurin toxicity0000000000 Other drug toxicity0000000000 Ureteric obstruction0000000000 Infection0013250024 Vascular causes1339120037 Recurrent/ de novo renal disease0000252524 Others00260041012 Unknown1335722112712291636 TOTAL3710032100411004110045100 Year 20042005200620072008 No.% % % % % Rejection33701875286526682672 Calcineurin toxicity0000120000 Other drug toxicity1200000000 Ureteric obstruction0000001300 Infection1214371326 Vascular causes4928491326 Recurrent/ de novo renal disease1200120000 Others00143741126 Unknown7152837513411 TOTAL4710024100431003810036100

18. Table 5.5.1: Patient survival, 1995-2008 Interval (years) No. % Survival SE 01925100- 11689951 31351911 5971881 10296811 12125752 *No.=Number at riskSE=standard error Figure 5.5.1: Patient survival, 1995-2008 Figure 5.5.2: Graft survival, 1995-2008 Table 5.5.2: Graft survival, 1995-2008 Interval (years) No. % Survival SE 01925100- 11689911 31351851 5971801 10296661 12125572 *No.=Number at riskSE=standard error Cumulative survival Transplant patient survival, 1995-2008 Duration in years 02468101214 0.00 0.25 0.50 0.75 1.00 Transplant graft survival, 1995-2008 Cumulative survival Duration in years 02468101214 0.00 0.25 0.50 0.75 1.00

19. Table 5.5.3: Patient survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live DonorCadaver Interval (years) No. % Survival SENo. % Survival SENo. % Survival SENo. % Survival SE 01125100-89100-454100-235100- 1102296185982395961168852 384392164893320951110783 55768814685424994190753 10177812166778389215714 127475355810448534638 *No.=Number at riskSE=standard error

20. Figure 5.5.3: Patient survival by type of transplant, 1995-2008 Transplant patient survival by Type of Transplant 1995-2008 Cumulative survival Duration in years 02468101214 0.00 0.25 0.50 0.75 1.00 Commercial cadaver Commercial live donor Live donor Cadaver

21. Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Type of Transplant Commercial Cadaver Commercial Live Donor Live DonorCadaver Interval (years) No. % Survival SENo. % Survival SENo. % Survival SENo. % Survival SE 1125100-89100-454100-235100- 1102294185972395921168773 384389164814320882110673 55768214674524984290623 10177702165478368315535 12746035359446044477 Table 14.5.4: Graft survival by type of transplant, 1995-2008 Type of Transplant Commercial Cadaver Commercial Live Donor Live Donor Cadaver Interval (years) No. % Survival SE No. % Survival SE No. % Survival SE No. % Survival SE 1125 100 - 89 100 - 454 100 - 235 100 - 1 1022 94 1 85 97 2 395 92 1 168 77 3 843 89 1 64 81 4 320 88 2 110 67 3 5 576 82 1 46 74 5 249 84 2 90 62 3 10 177 70 2 16 54 7 83 68 3 15 53 5 12 74 60 3 5 35 9 44 60 4 47 7 *No.=Number at riskSE=standard error Table 5.5.4: Graft survival by type of transplant, 1995-2008 *No.=Number at riskSE=standard error

22. Transplant graft survival by Type of Transplant 1995-2008 Cumulative survival Duration in years 02468101214 0.00 0.25 0.50 0.75 1.00 Commercial cadaver Commercial live donor Live donor Cadaver Figure 5.5.4: Graft survival by type of transplants, 1995-2008

23. Table 5.5.5: Patient survival by year of transplant (Living related transplant, 1995-2008) *No.=Number at riskSE=standard error Year of Transplant1995-20002001-2008 Interval (years)No.% SurvivalSENo.% SurvivalSE 0206100-248100- 1184971212951 3175961146942 516495286932 715594227922 Figure 5.5.5: Patient survival by year of transplant (Living related transplant, 1995-2008) Transplant patient survival by Year of Transplant 1995-2008 Cumulative survival Duration in years 01234567 0.00 0.25 0.50 0.75 1.00 Year 1995-2000 Year 2001-2008

24. Table5.5.6: Graft survival by year of transplant (Living related transplant, 1995-2008) Year of Transplant1994-19992000-2007 Interval (years)No.% SurvivalSENo.% SurvivalSE 0206100-248100- 1184892212942 3175862146912 516480386872 715576327784 *No.=Number at riskSE=standard error Figure 5.5.6: Graft survival by year of transplant (Living related transplant, 1995-2008) Transplant graft survival by Year of Transplant 1995-2008 Cumulative survival Duration in years 01234567 0.00 0.25 0.50 0.75 1.00 Year 1995-2000 Year 2001-2008

25. Table 5.5.7: Patient survival by year of transplant (Commercial cadaver transplant, 1995-2008) Year of Transplant1995-20002001-2008 Interval (years)No.% SurvivalSENo.% SurvivalSE 0417100-708100- 1394961630951 3373931473911 5336882240871 730585257822 *No.=Number at riskSE=standard error Figure 5.5.7: Patient survival by year of transplant (Commercial cadaver transplant, 1995-2008) Transplant patient survival by Year of Transplant 1995-2008 Cumulative survival Duration in years 01234567 0.00 0.25 0.50 0.75 1.00 Year 1995-2000 Year 2001-2008

26. Table 5.5.8: Graft survival by year of transplant (Commercial cadaver transplant, 1995-2008) Year of Transplant1995-20002001-2008 Interval (years)No. % Survival SENo. % Survival SE 0417100-708100- 1394941630941 3373892473891 5336822240832 730575257763 *No.=Number at riskSE=standard error Figure 5.5.8: Graft survival by year of transplant (Commercial cadaver transplant, 1995-2008) Transplant graft survival by Year of Transplant 1995-2008 Cumulative survival Duration in years 01234567 0.00 0.25 0.50 0.75 1.00 Year 1995-2000 Year 2001-2008

27. Table 5.6.1: Risk factors for IHD in renal transplant recipients at year 2006, 2007 and 2008 200620072008 Diabetes21 (1.4)25 (1.6)17 (1.2) Hypertension**455 (31.1)590 (37.5)514 (36.8) CKD177 (12.1)127 (8.1)116 (8.3) Diabetes + Hypertension** 155 (10.6)174 (11.0)172 (12.3) Diabetes + CKD18 (1.2)11 (0.7)21 (1.5) CKD + Hypertension**490 (33.5)516 (32.8)451 (32.3) Diabetes + CKD + Hypertension** 147 (10.0)132 (8.4)106 (7.6) **Hypertension: BP systolic > 140 and BP diastolic > 90 OR have either Beta blocker / Calcium channel blocker / ACE inhibitor / AIIRB / Other anti-hypertensive drugs GFR (mL/min/1.73m2) = 1.2*(140-age(year))*weight(kg) / creatinine (µmol/L) if male GFR (mL/min/1.73m2) = 0.85*(1.2*(140-age(year))*weight(kg) / creatinine (µmol/L) if female CKD stage III-GFR, 30-60 CKD stage IV-GFR, 15-30 CKD stage V-GFR, <15

28. Figure 5.6.1(a): Venn Diagram for Pre and Post Transplant Complications (in %) at year 2006 Figure 5.6.1(b): Venn Diagram for Pre and Post Transplant Complications (in %) at year 2007 Diabetes Hypertension CKD 8.1 1.6 37.5 0.732.8 11.0 8.4 Figure 5.6.1 (c): Venn Diagram for Pre and Post Transplant Complications (in %) at year 2008 Diabetes CKD Hypertension 8.3 1.2 36.8 1.532.3 12.3 7.6 Diabetes Hypertension CKD 12.1 1.4 31.1 1.233.5 10.6 10.0

29. Table 5.6.2(a): Systolic BP, 2006-2008 Year 200620072008 No.(%)No.(%)No.(%) Systolic BP<120249(15.64)240(14.23)279(18.61) Systolic BP <130395(24.81)392(23.25)367(24.48) Systolic BP 130-139483(30.34)529(31.38)441(29.42) Systolic BP 140-159353(22.17)409(24.26)329(21.95) Systolic BP 160-17993(5.84)99(5.87)73(4.87) Systolic BP >=18019(1.19)17(1.01)10(0.67) Figure 5.6.2(a): Systolic BP, 2006-2008 Percent 0 10 20 30 40 50 60 70 80 90 100 Systolic BP <120 Systolic BP <130 Systolic BP 130-139 Systolic BP 140-159 Systolic BP 160-179 Systolic BP >=180 200620072008

30. Table 5.6.2(b): Diastolic BP, 2006-2008 Year 200620072008 No.(%)No.(%)No.(%) Diastolic BP<80624(39.20)698(41.40)714(47.63) Diastolic BP <85586(36.81)609(36.12)514(34.29) Diastolic BP 85-8973(4.59)74(4.39)50(3.34) Diastolic BP 90-99244(15.33)261(15.48)195(13.01) Diastolic BP 100-10961(3.83)39(2.31)21(1.40) Diastolic BP >=1104(0.25)5(0.30)5(0.33) Figure 5.6.2(b): Diastolic BP, 2006-2008 Year Percent 0 10 20 30 40 50 60 70 80 90 100 Diastolic BP <80 Diastolic BP <85 Diastolic BP 85-89 Diastolic BP 90-99 Diastolic BP 100-109 Diastolic BP >=110 200620072008

31. Table 5.6.3: CKD stages, 2006-2008 Year 200620072008 No.(%)No.(%)No.(%) CKD stage 1116(7.33)180(10.79)145(9.82) CKD stage 2533(33.67)592(35.49)561(37.98) CKD stage 3805(50.85)760(45.56)642(43.47) CKD stage 4107(6.76)113(6.77)106(7.18) CKD stage 522(1.39)23(1.38)23(1.56) Figure 5.6.3: CKD stages by year Percent Year 0 10 20 30 40 50 60 70 80 90 100 CKD Stage 1 CKD Stage 2 CKD Stage 3 CKD Stage 4 CKD Stage 5 200620072008

32. Table 5.6.4: BMI, 2006-2008 Year 200620072008 No.(%)No.(%)No.(%) BMI <20242(15.20)253(15.01)244(16.28) BMI 20-25647(40.64)658(39.03)588(39.23) BMI 25-30498(31.28)533(31.61)455(30.35) BMI > 30205(12.88)242(14.35)212(14.14) Figure 5.6.4: BMI by year Percent Year 0 10 20 30 40 50 60 70 80 90 100 BMI <20 BMI 20-25 BMI 25-30 BMI > 30 200620072008

33. Table 5.6.5(a): LDL, 2006-2008 Figure 5.6.5(a): LDL, 2006-2008 Percent Year 0 10 20 30 40 50 60 70 80 90 100 LDL <2.6 LDL 2.6-3.4 LDL >= 3.4 200620072008 Year 200620072008 No.(%)No.(%)No.(%) LDL < 2.6492(30.90)527(31.26)534(35.62) LDL 2.6-3.4738(46.36)778(46.14)669(44.63) LDL >= 3.4362(22.74)381(22.60)296(19.75)

34. Table 5.6.5(b): Total Cholesterol, 2006-2008 Year 200620072008 No.(%)No.(%)No.(%) Total Cholesterol <4.1160(10.05)210(12.46)184(12.27) Total Cholesterol 4.1-5.1490(30.78)539(31.97)476(31.75) Total Cholesterol 5.1-6.2700(43.97)719(42.65)629(41.96) Total Cholesterol 6.2- 7.2173(10.87)159(9.43)143(9.54) Total Cholesterol > 7.269(4.33)59(3.50)67(4.47) Figure 5.6.5(b): Total Cholesterol, 2006-2008 Percent Year 0 10 20 30 40 50 60 70 80 90 100 Total Cholesterol <4.1 Total Cholesterol 4.1-5.1 Total Cholesterol 5.1-6.2 Total Cholesterol 6.2-7.2 Total Cholesterol > 7.2 200620072008

35. Table 5.6.5(c): HDL, 2006-2008 Year 200620072008 No.(%)No.(%)No.(%) HDL <1104(6.53)108(6.41)93(6.20) HDL 1-1.3302(18.97)350(20.76)338(22.55) HDL >1.31186(74.50)1228(72.84)1068(71.25) Figure 5.6.5(c): HDL by year Percent Year 0 10 20 30 40 50 60 70 80 90 100 HDL <1 HDL, 1-1.3 HDL > 1.3 200620072008

36. Table 5.6.6(a): Treatment for hypertension, 2006-2008 YearNo. % on anti- hypertensives % no 1 anti- hypertensive drug % on 2 anti- hypertensives % on 3 anti- hypertensives 2006159286342617 2007168685253121 2008149986273121 Table 5.6.6(b): Distribution of Systolic BP without anti-hypertensives, 2006-2008 YearNo.MeanSDMedianLQUQ % Patients ≥ 160mmHg 2006189123.814.41201171304 2007196125.216.51201131344 200817112415.61201101304 Table 5.6.6(c): Distribution of Diastolic BP without anti-hypertensives, 2006-2008 YearNo.MeanSDMedianLQUQ % patients ≥ 90mmHg 200618976.410.380708011 200719676.61080708012 200817075.210.280708011

37. Table 5.6.6(d): Distribution of Systolic BP on anti-hypertensives, 2006-2008 YearNo.MeanSDMedianLQUQ % Patients ≥ 160mmHg 20061334131.716.31301201408 20071388132.6161301201408 20081241129.916.61301201406 Table 5.6.6(e): Distribution of Diastolic BP on anti-hypertensives, 2006-2008 YearNo.MeanSDMedianLQUQ % Patients ≥ 90 mmHg 2006133479.29.980708622 2007138779.19.680708520 2008122777.69.980708017

38. Table 5.7.1: Cumulative distribution of QoL-Index score in Transplant recipients 1999 - 2008 QoL score Number of patients1179 Centile 00 0.059 0.19 0.25 (LQ)10 0.5 (median)10 0.75 (UQ)10 0.910 0.9510 1 Figure 5.7.1: Cumulative distribution of QoL-Index score in Transplant recipients, 1999 - 2008 0.2.4.6.8 1 Cumulative Distribution 0246810 QL-Index Score Cumulative distribution of QOL by Modality, Transplant Patients

39. Table 5.7.2: Cumulative distribution of QoL-Index score in relation to Diabetes mellitus, Transplant recipients 1999 - 2008 Diabetes mellitusNoYes Number of patients1054125 Centile 000 0.0597 0.1108 0.25 (LQ)109 0.5 (median)10 0.75 (UQ)10 0.910 0.9510 1 Figure 5.7.2: Cumulative distribution of QoL-Index score in relation to Diabetes mellitus, Transplant recipients 1999 – 2008

40. Table 5.7.3: Cumulative distribution of QoL-Index score in relation to Gender, Transplant recipients 1999-2008 GenderMaleFemale Number of patients730449 Centile 000 0.0599 0.1109 0.25 (LQ)10 0.5 (median)10 0.75 (UQ)10 0.910 0.9510 1 Figure 5.7.3: Cumulative distribution of QoL-Index score in relation to Gender, Transplant recipients 1999 – 2008

41. Table 5.7.4: Cumulative distribution of QoL-Index score in relation to Age, Transplant recipients 1999-2008 Age group (years)<2020-3940-59≥60 Number of patients 11747251575 Centile 00000 0.059987 0.110 98 0.25 (LQ)10 9 0.5 (median)10 0.75 (UQ)10 0.910 0.9510 1 Figure 5.7.4: Cumulative distribution of QoL-Index score in relation to Age, Transplant recipients 1999-2008

42. Table 5.7.5: Cumulative distribution of QoL-Index score in relation to Year of entry, Transplant recipients 1999-2008 Year of Entry1999200020012002200320042005200620072008 Number of patients1011101261431361671371287655 Centile 00000000000 0.059899899976 0.11099 9 98 0.25 (LQ)10 0.5 (median)10 0.75 (UQ)10 0.910 0.9510 1 Figure 5.7.5: Cumulative distribution of QoL-Index score in relation to Year of entry, Transplant recipients 1999 – 2008