Mortality on a renal transplantation waiting list.

Renal transplantation (Tx) represents the treatment of choice for patients with advanced chronic kidney disease (ACKD), but the shortage of available organs for those with a high level of comorbidity can significantly increase mortality in patients who are candidates for Tx. This constitutes a worrying health care problem, given the increase in incident and prevalent patients with ACKD, and is especially concerning amongst those with ACKD that is secondary to conditions with a high level of comorbidity, such as diabetes or arterial hypertension. In addition, this can increase the number of patients on the waiting list (WL) and cause the rapid raising of mortality figures. Therefore, nowadays it is relevant to identify the causes of death and the mortality risk factors in this population, to know the barriers that limit access to Tx and to apply predictive mortality models, with the aim of improving survival rates from these illnesses. In this review on the mortality of the patients on the WL, the following aspects will be addressed: 1) the magnitude of this problem and the importance of certain epidemiological data; 2) the mortality risk factors in these patients and the barriers that exist against access to Tx, which could increase mortality rates amongst this population; 3) evaluation of the risk of death in patients on dialysis from comorbidity; 4) assessment of mortality on the WL, via regression analysis of competitive risks, and the generation of a compound risk model, which includes comorbidity and other uraemic factors.