title: The association between recipient alcohol dependency and long-term graft and recipient survival.
abstract: BACKGROUND
  The causative role of alcohol consumption in renal disease is controversial, and its effect on renal graft and recipient survival has not been previously studied.
  
  
  METHODS
  We analysed the association between pre-transplant [at the time of end-stage renal disease (ESRD) onset] alcohol dependency and renal graft and recipient survival. The United States Renal Data System (USRDS) records of kidney transplant recipients 18 years or older transplanted between 1 January 1995 and 31 December 2002 were examined. We used Kaplan-Meier analysis and Cox regression models adjusted for covariates to analyse the association between pre-transplant alcohol dependency and graft and recipient survival.
  
  
  RESULTS
  In an entire study cohort of 60 523, we identified 425 patients with a history of alcohol dependency. Using Cox models, alcohol dependency was found to be associated with increased risk of death-censored graft failure [hazard ratio (HR) 1.38, P < 0.05] and increased risk of transplant recipient death (HR 1.56, P < 0.001). Subgroup analysis demonstrated an association of alcohol-dependency with recipient survival and death-censored graft survival in males (but not in females), and in both white and non-white racial subgroups.
  
  
  CONCLUSIONS
  We concluded that alcohol dependency at the time of ESRD onset is a risk factor for renal graft failure and recipient death.
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, UT 84112, USA.
authors.forename: Abdou S
authors.initials: AS
authors.lastname: Gueye
authors.forename: Madhukar
authors.initials: M
authors.lastname: Chelamcharla
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Baird
authors.forename: Cuong
authors.initials: C
authors.lastname: Nguyen
authors.forename: Hongying
authors.initials: H
authors.lastname: Tang
authors.forename: Anna L
authors.initials: AL
authors.lastname: Barenbaum
authors.forename: James K
authors.initials: JK
authors.lastname: Koford
authors.forename: Fuad
authors.initials: F
authors.lastname: Shihab
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Goldfarb-Rumyantzev
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000401:mortality; D000437:Alcoholism / Q000150:complications* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology