The association between recipient alcohol dependency and long-term graft and recipient survival.
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.
Gueye
Abdou S
AS
Department of Biomedical Informatics, University of Utah, Salt Lake City, UT 84112, USA.
Chelamcharla
Madhukar
M
Baird
Bradley C
BC
Nguyen
Cuong
C
Tang
Hongying
H
Barenbaum
Anna L
AL
Koford
James K
JK
Shihab
Fuad
F
Goldfarb-Rumyantzev
Alexander S
AS
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