Impact of graft failure on patient survival on dialysis: a comparison of transplant-naïve and post-graft failure mortality rates

While the number of patients returning to dialysis after graft failure (GF) is increasing steadily, the impact of a failed kidney transplant on mortality among dialysis patients has not been studied well. Data from the Canadian Organ Replacement Register were utilized to examine the outcomes of an i...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2005-02, Vol.20 (2), p.387-391
Main Authors: RAO, Panduranga S, SCHAUBEL, Douglas E, SARAN, Rajiv
Format: Article
Language:English
Subjects:
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Canada
Cohort Studies
Continental Population Groups
Emergency and intensive care: renal failure. Dialysis management
Female
Humans
Intensive care medicine
Kidney Diseases - classification
Kidney Diseases - surgery
Kidney Transplantation - mortality
Kidney Transplantation - physiology
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Probability
Proportional Hazards Models
Registries
Regression Analysis
Renal failure
Renal Replacement Therapy - mortality
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Survival Analysis
Treatment Failure
Treatment Outcome
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Summary:While the number of patients returning to dialysis after graft failure (GF) is increasing steadily, the impact of a failed kidney transplant on mortality among dialysis patients has not been studied well. Data from the Canadian Organ Replacement Register were utilized to examine the outcomes of an incident cohort of patients (n = 25,632) initiating renal replacement therapy (RRT) between 1990 and 1998. Cox regression was used to compare covariate-adjusted mortality among five RRT categories: transplant-naive dialysis, cadaveric primary renal transplant, living-donor primary renal transplant, post-GF dialysis and retransplant. RRT category-specific hazard ratios (HR) were estimated using Cox regression and adjusting for age, sex, race, calendar period, primary renal diagnosis and comorbid conditions. Mortality among post-GF dialysis patients was approximately equal to that of transplant-naive patients (HR = 0.90; P = 0.30) while the HR for retransplanted patients was significantly decreased, relative to the transplant-naive group (HR = 0.35; P
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfh595