title: Which patients are more likely to benefit from renal transplantation?
abstract: BACKGROUND
  We evaluated whether the advantages conferred by renal transplantation encompass all individuals or whether they favor more specific groups of patients.
  
  
  METHODS
  One thousand and fifty-eight patients on the transplant waiting list and 270 receiving renal transplant were studied. End points were the composite incidence of CV events and death. Patients were followed up from date of placement on the list until transplantation, CV event, or death (dialysis patients), or from the date of transplantation, CV event, return to dialysis, or death (transplant patients).
  
  
  RESULTS
  Younger patients with no comorbidities had a lower incidence of CV events and death independently of the treatment modality (log-rank=0.0001). Renal transplantation was associated with better prognosis only in high-risk patients (p=0.003).
  
  
  CONCLUSIONS
  Age and comorbidities influenced the prevalence of CV complications and death independently of the treatment modality. A positive effect of renal transplantation was documented only in high-risk patients. These findings suggest that age and comorbidities should be considered indication for early transplantation even considering that, as a group, such patients have a shorter survival compared with low-risk individuals.
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: José Jayme Galvão
authors.initials: JJ
authors.lastname: De Lima
authors.forename: Luís Henrique Wolff
authors.initials: LH
authors.lastname: Gowdak
authors.forename: Flávio Jota
authors.initials: FJ
authors.lastname: de Paula
authors.forename: Luiz Antonio Machado
authors.initials: LA
authors.lastname: César
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
authors.forename: Luiz A
authors.initials: LA
authors.lastname: Bortolotto
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate; D014850:Waiting Lists