title: Similar patient survival following kidney allograft failure compared with non-transplanted patients.
abstract: Data from the national French Renal Epidemiology and Information Network (REIN) registry were used to compare survival between transplant recipients under age 65 who resumed dialysis after graft failure during 2007-2009 and transplant-naïve incident dialysis patients matched for age, gender, diabetes mellitus, and year of starting dialysis. Among 911 transplant patients who returned to dialysis, 103 had died by 1 January 2011. Multivariate analysis showed that age over 48 years, coronary artery disease, peripheral artery disease, and inability to walk unassisted were significant predictors of death. In the case-control analysis, the observed mortality rates in 778 transplant failure and 778 transplant-naïve dialysis patients were 11.8 and 10.8%, respectively. Kaplan-Meier estimates of survival after transplant failure vs. the transplant-naïve controls were 95.2 vs. 94.1% at 1 year, 90.3 vs. 88.8% at 2 years, and 84.2 vs. 80.2% at 3 years (log rank P=0.197 overall). Dialysis in transplant failure vs. transplant-naïve patients was not associated with significantly increased mortality. At the start of dialysis, the serum creatinine levels and the rate of unplanned dialysis were significantly lower in transplant failure patients compared with transplant-naïve controls. Thus, in patients under 65 years of age in France, survival of dialysis patients after graft loss is similar to that of incident dialysis patients who have not undergone transplantation.
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, Hôpital Lapeyronie, University of Montpellier Medical School, Montpellier, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Mourad
authors.affiliation: Department of Statistics and Epidemiology, University of Montpellier Medical School, Montpellier, France.
authors.forename: Johanna
authors.initials: J
authors.lastname: Minguet
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, Hôpital Lapeyronie, University of Montpellier Medical School, Montpellier, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Pernin
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, Hôpital Lapeyronie, University of Montpellier Medical School, Montpellier, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Garrigue
authors.affiliation: Department of Nephrology and Transplantation, Hôpital Saint Louis, Paris, France.
authors.forename: Marie-Noelle
authors.initials: MN
authors.lastname: Peraldi
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, Hôpital Brabois, Nancy, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Kessler
authors.affiliation: French Biomedicine Agency, Department of Statistics, Saint-Denis, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Jacquelinet
authors.affiliation: French Biomedicine Agency, Department of Statistics, Saint-Denis, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Couchoud
authors.affiliation: Department of Statistics and Epidemiology, University of Montpellier Medical School, Montpellier, France.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Duny
authors.affiliation: Department of Statistics and Epidemiology, University of Montpellier Medical School, Montpellier, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Daurès
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis / Q000401:mortality; D012307:Risk Factors; D017211:Treatment Failure