Pretransplant dialysis duration and risk of death after kidney transplantation in the current era

Although longer pretransplant dialysis has been associated with poor kidney transplant outcome, no data about this association exist from the current era or from Europe. We studied the association of pretransplant dialysis duration on outcomes after kidney transplantation across two different time p...

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Veröffentlicht in:Transplantation 2014-08, Vol.98 (4), p.458-464
Hauptverfasser: Helanterä, Ilkka, Salmela, Kaija, Kyllönen, Lauri, Koskinen, Petri, Grönhagen-Riska, Carola, Finne, Patrik
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container_end_page 464
container_issue 4
container_start_page 458
container_title Transplantation
container_volume 98
creator Helanterä, Ilkka
Salmela, Kaija
Kyllönen, Lauri
Koskinen, Petri
Grönhagen-Riska, Carola
Finne, Patrik
description Although longer pretransplant dialysis has been associated with poor kidney transplant outcome, no data about this association exist from the current era or from Europe. We studied the association of pretransplant dialysis duration on outcomes after kidney transplantation across two different time periods. All recipients of first kidney transplantation between 1990 and 2010 in Finland were included (N=3,105) in this observational follow-up study of an inception cohort. The association of the duration of pretransplant dialysis with patient and graft survival after transplantation was analyzed with multivariable Cox regression and competing risk analyses. The association of pretransplant dialysis duration with the risk of specific causes of death (cardiovascular, infectious, or other) was analyzed using competing risk analysis. Longer duration of pretransplant dialysis was an independent risk factor for patient death after transplantation (risk ratio [RR] 1.14 per 1-year increase) in the whole study population, but not for graft loss. Risk of death was increased in patients with greater than 12 months of pretransplant dialysis. After further adjustment in patients transplanted in 2000 to 2010, longer duration of dialysis remained an independent risk factor (RR 1.23 per 1-year increase). Longer duration of dialysis was an independent predictor of death resulting from cardiovascular diseases (RR 1.14 per 1-year increase), but not for other causes. The risk of death associated with longer duration of dialysis has not decreased over time, but remains an independent predictor of patient death after kidney transplantation because of increased risk of death resulting from cardiovascular diseases.
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subjects Adult
Aged
Female
Graft Survival
Humans
Kidney Transplantation - mortality
Male
Middle Aged
Renal Dialysis
Risk
Time Factors
Waiting Lists
title Pretransplant dialysis duration and risk of death after kidney transplantation in the current era
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