Association of pre-transplant dialysis duration with outcome in kidney transplant recipients: a prevalent cohort study.
BACKGROUND
Dialysis treatment prior to transplantation may contribute to premature mortality and graft loss in kidney-transplanted patients. In this prevalent cohort study (TransQol-HU Study), we analyzed the association between pre-transplant dialysis duration versus mortality and death-censored graft loss in kidney-transplanted patients.


METHODS
Data from 926 kidney-transplanted patients followed at a single outpatient transplant center were analyzed. Socio-demographic parameters, laboratory data, medical history, donor characteristics and information on co-morbidities were collected at baseline. Data on 5-year outcome (graft loss, mortality) were collected.


RESULTS
In multivariate analyses, pre-transplant dialysis duration was an independent risk factor for mortality (HR(for each month increase) = 1.011; 95% CI: 1.005-1.016) and also for death-censored graft loss (HR(for each month increase) = 1.008; 95% CI: 1.001-1.015) after adjustment for several co-variables. In the multivariate model, patients with less than 1 year (HR = 0.498; 95% CI: 0.302-0.820; P = 0.006) and 1-3 years (HR = 0.577; 95% CI: 0.371-0.899; P = 0.015) of pre-transplant dialysis had significantly better survival after transplantation compared to those with more than 3 years on dialysis.


CONCLUSIONS
These findings add further strength to existing evidence about the significant association between longer pre-transplant dialysis duration and poor outcome in kidney-transplanted patients.
Remport
Adam
A
Department of Nephrology-Hypertension, Institute of Internal Medicine, St Imre Teaching Hospital, Budapest, Hungary.
Keszei
Andras
A
Vamos
Eszter Panna
EP
Novak
Marta
M
Jaray
Jeno
J
Rosivall
Laszlo
L
Mucsi
Istvan
I
Molnar
Miklos Zsolt
MZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000401:mortality; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D015995:Prevalence; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult