Primary care visits after kidney transplant linked to better cholesterol control

Kidney transplant recipients who see a primary care provider after surgery are more likely to have their cholesterol under control and to be prescribed statins, according to a new retrospective cohort study published in BMC Nephrology.

Primary care providers are central partners in chronic disease risk management, yet their involvement in the care of transplant recipients has not been well characterized.

The study was a single-center retrospective cohort analysis using electronic health record data. The researchers evaluated clinical and socioeconomic factors associated with primary care utilization after kidney transplantation. They then used time-varying survival analyses to examine associations between primary care visits and outcomes of interest. The primary outcomes were mortality, hospitalization, and graft failure. Secondary outcomes focused on care quality, including LDL cholesterol and hemoglobin A1c control and monitoring, and statin prescription. To guard against bias from follow-up time, the team also performed landmark analyses beginning at one and two years after transplant, with exposure fixed before follow-up time was counted.

Among 815 kidney transplant recipients, 39 percent had at least one primary care visit after transplant. The researchers identified several factors independently associated with primary care utilization: female sex, Black or Hispanic race or ethnicity, hyperlipidemia, a higher Elixhauser comorbidity score, and use of the immunosuppressant belatacept.

Perhaps the most striking result was what the study did not find. There was no statistically significant association between primary care utilization and mortality, hospitalization, or graft failure.

However, primary care engagement was clearly linked to better dyslipidemia management. Patients who saw a primary care provider had significantly improved LDL cholesterol control, with an adjusted hazard ratio of 1.95, and were more likely to receive a statin prescription, with an adjusted hazard ratio of 1.47.

The landmark analyses reinforced the lipid findings. In analyses beginning at one and two years after transplant, the association with LDL control persisted, with adjusted hazard ratios of 2.08 and 2.05 respectively. Associations with statin prescription and hemoglobin A1c control, however, did not hold in these landmark models.

The authors emphasize that these associations are observational and that residual confounding cannot be excluded.

Despite these limitations, the study offers a data-driven case for strengthening the partnership between transplant nephrology and primary care. The authors conclude that primary care utilization was associated with improved dyslipidemia management among kidney transplant recipients and that the findings show the potential value of primary care partnerships in caring for this high-risk population.

Subject of Research: Primary care utilization and its association with cardiovascular risk management outcomes in kidney transplant recipients

Article Title: Primary care engagement after kidney transplantation: predictors and outcomes

Article References: Qian, L., Faulkner, S., Virmani, S., Wilson, F. P., Yamamoto, Y., Sureshanand, S., Cohen, E., Miller, M., Bow, L., Menon, M. C., Moledina, D. G., & Mansour, S. G. (2026). Primary care engagement after kidney transplantation: predictors and outcomes. BMC Nephrology. https://doi.org/10.1186/s12882-026-05463-2

Image Credits: AI Generated

DOI: 10.1186/s12882-026-05463-2

Keywords: kidney transplantation, primary care, LDL cholesterol, statin prescription, cardiovascular risk, graft failure, retrospective cohort study, dyslipidemia management, transplant nephrology, interdisciplinary care, Primary, care