Reduced survival in patients who return to dialysis after kidney allograft failure

Clin Transplant. 2020 Sep;34(9):e14014. doi: 10.1111/ctr.14014. Epub 2020 Jul 15.

Abstract

Background: The outcome of patients who return to dialysis after Kidney allograft failure (KAF) remains unclear. Our aim was to compare the outcome of KAF patients vs two different types of transplant naive incident dialysis (TNID) patients, those on the waiting list (WL) and those with a kidney transplant contraindication (KTC).

Methods: We performed an observational study using data from the Argentinian Dialysis Registry between 2005 and 2016. We compare mortality between KAF, WL, and KTC.

Results: We included 75 722 patients of which 2734 were KAF. Survival between the three cohorts (KAF vs WL (n = 14 630) vs KTC (n = 58 358) revealed a significant difference (log-rank test: P < .0001) indicating worse survival for KTC patients and best survival for WL. We found that KAF patients had as poor outcome as KTC patients after multivariate adjustment. Cox regression showed that age >65 years: HR: 1.845 (1.79-1.89) P < .0001, transient catheter: HR: 1.303 (1.26-1.34) P < .0001, diabetic: HR: 1.273 (1.22-1.31) P < .0001, hepatitis C: HR: 1.156 (1.09-1.22) P < .0001, and albumin: HR: 1.247 (1.21-1.28) P < .0001 were associated with mortality.

Conclusion: Patients who return to dialysis after KAF have higher mortality than WL patients and similar to KTC patients.

Keywords: dialysis; kidney allograf failure; patients survival.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Allografts
  • Humans
  • Kidney
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation*
  • Renal Dialysis
  • Transplantation, Homologous