title: Kidney Transplantation, Cardiovascular Risk, and Long-Term Dialysis in Japan.
abstract: BACKGROUND
  The waiting time for deceased-donor kidney-only transplantations in Japan is long. Herein, we assessed the effect of length of dialysis on the outcomes of these patients.
  
  
  METHODS
  We divided patients into 2 groups based on length of dialysis (Group A, <15 years, and Group B, ≥15 years), and compared the background and outcomes after kidney transplantation.
  
  
  RESULTS
  Group A included 210 patients and Group B included 35 patients. In Group B, 20% of transplants were from living donors. Patient age (P = .017) and the hepatitis C infection rate (P = .018) were significantly higher in Group B, whereas hypertension (P = .011), diabetes (P = .041), and ABO-incompatibility rates (P = .015) were significantly higher in Group A. The 5- and 10-year survival rates were 97.0% and 95.4%, respectively, in Group A and 97.1% and 97.1%, respectively, in Group B. The 5- and 10-year graft survival rates were 95.4% and 84.8%, respectively, in Group A and 97.1% and 73.1%, respectively, in Group B. There were no significant differences between the groups in patient survival (P = .74) and graft survival (P = .72). The 5- and 10-year cardiovascular event-free survival rates were 95.9% and 92.4%, respectively, in Group A and 88.6% and 76.8%, respectively, in Group B. Cardiovascular event-free survival was significantly higher in Group A (P = .038). Cox stepwise multivariate analysis indicated that length of dialysis was a significant predictor of cardiovascular events (hazard risk, 1.007; range, 1.001-1.012; P = .012).
  
  
  CONCLUSIONS
  The prognosis after kidney transplantation is promising even after a long length of dialysis, although evaluation of the cardiovascular risk is needed in these cases.
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Tada
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan. Electronic address: mhase@fujita-hu.ac.jp.
authors.forename: M
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kusaka
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Shiroki
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hoshinaga
authors.affiliation: Department of Organ Transplantation, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Organ Transplantation, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kenmochi
authors.affiliation: Fujita Health University School of Health Science, Aichi, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakai
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Koide
authors.affiliation: Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yuzawa
mesh_terms: D000328:Adult; D001787:Blood Group Incompatibility; D002318:Cardiovascular Diseases / Q000209:etiology*; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation / Q000379:methods / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014850:Waiting Lists