Impact of clinical condition at restarting dialysis on outcome after kidney allograft loss: a single-center experience

Transplant Proc. 2010 Jun;42(5):1708-12. doi: 10.1016/j.transproceed.2010.02.085.

Abstract

Background: The purpose of this paper was to determine the impact of the clinical condition of the patient at the restart of dialysis on long-term survival after renal graft loss.

Methods: We performed an analysis of 110 patients with renal allograft failure compared with 115 hemodialysis patients without kidney transplantation.

Results: There was a relatively high glomerular filtration rate, low serum albumin, and greater prevalence of infection among graft loss patients compared with the never-transplanted patients. Patient survival after allograft loss was significantly lower than that of never-transplanted patients (P = .024) with 63.4% patients succumbing in the first 3 months. Serum hepatitis B virus (HBV) positivity, cardiovascular disease (CVD) and malnutrition were independent risk factors for graft loss patient upon COX regression analysis.

Conclusions: Serum HBV positive, complicated with CVD and malnutrition were independent risk factors for the graft loss among patients who restarted hemodialysis. More attention should be paid to treat complications of transplant recipients in K/DOQI 4 and 5 stages.

MeSH terms

  • Adult
  • Aspartate Aminotransferases / blood
  • Cadaver
  • Diabetes Mellitus / epidemiology
  • Female
  • Glomerular Filtration Rate
  • Graft Rejection / drug therapy
  • Graft Rejection / etiology
  • Graft Rejection / virology
  • Hemorrhage / epidemiology
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infections / epidemiology
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Kidney Transplantation / pathology
  • Male
  • Middle Aged
  • Postoperative Complications / classification
  • Postoperative Complications / epidemiology
  • Postoperative Complications / therapy
  • Renal Dialysis / methods*
  • Tissue Donors
  • Treatment Failure*

Substances

  • Immunosuppressive Agents
  • Aspartate Aminotransferases