The Relationship Between Kidney Function and Long-term Graft Survival After Kidney Transplant
Background Whether chronic kidney disease (CKD) staging provides a useful framework for predicting outcomes after kidney transplant is unclear. Study Design Retrospective cohort study. Setting & Participants We used data from the Patient Outcomes in Renal Transplantation (PORT) Study, including...
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| Veröffentlicht in: | American journal of kidney diseases 2011-03, Vol.57 (3), p.466-475 |
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| creator | Kasiske, Bertram L., MD Israni, Ajay K., MD, MS Snyder, Jon J., PhD, MS Skeans, Melissa A., MS |
| description | Background Whether chronic kidney disease (CKD) staging provides a useful framework for predicting outcomes after kidney transplant is unclear. Study Design Retrospective cohort study. Setting & Participants We used data from the Patient Outcomes in Renal Transplantation (PORT) Study, including 13,671 transplants from 12 centers during 10 years of follow-up. Predictor Estimated glomerular filtration rate (eGFR; in milliliters per minute per 1.73 m2 ) at 12 months posttransplant. Outcomes All-cause graft failure (a composite end point consisting of return to dialysis therapy, pre-emptive retransplant, or death with function), death-censored graft failure, and death with a functioning graft. Measurements The relationship between 12-month eGFR and subsequent graft outcomes through 10 years posttransplant was assessed using Cox proportional hazards analyses. Results Stage 3 included 63% of patients and was subdivided into stages 3a (eGFR, 45-59 mL/min/1.73 m2 ; 34%) and 3b (eGFR, 30-44 mL/min/1.73 m2 ; 29%). Compared with stage 2 (eGFR, 60-89 mL/min/1.73 m2 ; 24%), adjusted Cox proportional HRs for graft failure were 1.12 (95% CI, 1.01-1.24; P = 0.04) for stage 3a, 1.50 (95% CI, 1.35-1.66; P < 0.001) for stage 3b, 2.86 (95% CI, 2.53-3.22; P < 0.001) for stage 4 (eGFR, 15-29 mL/min/1.73 m2 ; 9%), and 13.2 (95% CI, 10.7-16.4; P < 0.001) for stage 5 (eGFR |
| doi_str_mv | 10.1053/j.ajkd.2010.10.054 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_853222543</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0272638610016689</els_id><sourcerecordid>853222543</sourcerecordid><originalsourceid>FETCH-LOGICAL-c440t-8530317b12ed02202aa16f0a068ac2b1c1db68c02dcfeaed17404c61fe5d39f43</originalsourceid><addsrcrecordid>eNp9kU1vEzEQhi1ERUPhD3BAviBOG8Yf6-xKCKlUtKBGQqLhiCzHnqXebrzB3g3Kv8dLUpB66MnS-HlnRs8Q8orBnEEp3rVz0965OYe_hTmU8gmZsZKLQlWiekpmwBe8UKJSp-R5Si0A1EKpZ-SUM14uuBQz8mN1i_QbdmbwfUi3fks_4vAbMdBr7wLu6eUY7PRHTXB02YefxYBxQ6-iaQZ6M8ad35mOnje5eh9ZRRPStjNheEFOGtMlfHl8z8j3y0-ri8_F8uvVl4vzZWGlhKGoSgGCLdaMowPOgRvDVAMGVGUsXzPL3FpVFrizDRp0bCFBWsUaLJ2oGynOyNtD323sf42YBr3xyWKXd8B-TDoP4JyXUmSSH0gb-5QiNnob_cbEvWagJ6u61ZNVPVmdatlqDr0-th_XG3T_IvcaM_DmCJhkTddkAdan_5yoRa0ky9z7A4dZxs5j1Ml6DBadj2gH7Xr_-B4fHsRt54PPE-9wj6ntxxiyZs104hr0zXT_6fwMgClV1eIPgU-qOQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>853222543</pqid></control><display><type>article</type><title>The Relationship Between Kidney Function and Long-term Graft Survival After Kidney Transplant</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Kasiske, Bertram L., MD ; Israni, Ajay K., MD, MS ; Snyder, Jon J., PhD, MS ; Skeans, Melissa A., MS</creator><creatorcontrib>Kasiske, Bertram L., MD ; Israni, Ajay K., MD, MS ; Snyder, Jon J., PhD, MS ; Skeans, Melissa A., MS ; Patient Outcomes in Renal Transplantation (PORT) Investigators</creatorcontrib><description><![CDATA[Background Whether chronic kidney disease (CKD) staging provides a useful framework for predicting outcomes after kidney transplant is unclear. Study Design Retrospective cohort study. Setting & Participants We used data from the Patient Outcomes in Renal Transplantation (PORT) Study, including 13,671 transplants from 12 centers during 10 years of follow-up. Predictor Estimated glomerular filtration rate (eGFR; in milliliters per minute per 1.73 m2 ) at 12 months posttransplant. Outcomes All-cause graft failure (a composite end point consisting of return to dialysis therapy, pre-emptive retransplant, or death with function), death-censored graft failure, and death with a functioning graft. Measurements The relationship between 12-month eGFR and subsequent graft outcomes through 10 years posttransplant was assessed using Cox proportional hazards analyses. Results Stage 3 included 63% of patients and was subdivided into stages 3a (eGFR, 45-59 mL/min/1.73 m2 ; 34%) and 3b (eGFR, 30-44 mL/min/1.73 m2 ; 29%). Compared with stage 2 (eGFR, 60-89 mL/min/1.73 m2 ; 24%), adjusted Cox proportional HRs for graft failure were 1.12 (95% CI, 1.01-1.24; P = 0.04) for stage 3a, 1.50 (95% CI, 1.35-1.66; P < 0.001) for stage 3b, 2.86 (95% CI, 2.53-3.22; P < 0.001) for stage 4 (eGFR, 15-29 mL/min/1.73 m2 ; 9%), and 13.2 (95% CI, 10.7-16.4; P < 0.001) for stage 5 (eGFR <15 mL/min/1.73 m2 ; 1%). For stage 1 (eGFR ≥90 mL/min/1.73 m2 ; 3%), risk of graft failure was increased (1.41 [95% CI, 1.13-1.75]; P < 0.001), likely due to serum creatinine associations independent of kidney function. Similar associations were seen between CKD stages and mortality. Limitations Retrospective study; lack of gold-standard measurements of true GFR; lack of measures of comorbidity, inflammation, muscle mass, proteinuria, and other noncreatinine markers of eGFR. Conclusions CKD stages validated in the general population provide a useful framework for predicting outcomes after kidney transplant.]]></description><identifier>ISSN: 0272-6386</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2010.10.054</identifier><identifier>PMID: 21257243</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Chronic kidney disease ; estimated glomerular filtration rate ; Female ; Follow-Up Studies ; Glomerular Filtration Rate - physiology ; graft outcomes ; Graft Rejection - epidemiology ; Graft Survival ; Humans ; Incidence ; Kidney Failure, Chronic - surgery ; kidney transplant ; Kidney Transplantation ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Nephrology ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Prognosis ; Renal failure ; Retrospective Studies ; Survival Rate - trends ; Time Factors ; United States - epidemiology ; Urinary system involvement in other diseases. Miscellaneous ; Young Adult</subject><ispartof>American journal of kidney diseases, 2011-03, Vol.57 (3), p.466-475</ispartof><rights>National Kidney Foundation, Inc.</rights><rights>2011 National Kidney Foundation, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-8530317b12ed02202aa16f0a068ac2b1c1db68c02dcfeaed17404c61fe5d39f43</citedby><cites>FETCH-LOGICAL-c440t-8530317b12ed02202aa16f0a068ac2b1c1db68c02dcfeaed17404c61fe5d39f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.ajkd.2010.10.054$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23939641$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21257243$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kasiske, Bertram L., MD</creatorcontrib><creatorcontrib>Israni, Ajay K., MD, MS</creatorcontrib><creatorcontrib>Snyder, Jon J., PhD, MS</creatorcontrib><creatorcontrib>Skeans, Melissa A., MS</creatorcontrib><creatorcontrib>Patient Outcomes in Renal Transplantation (PORT) Investigators</creatorcontrib><title>The Relationship Between Kidney Function and Long-term Graft Survival After Kidney Transplant</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description><![CDATA[Background Whether chronic kidney disease (CKD) staging provides a useful framework for predicting outcomes after kidney transplant is unclear. Study Design Retrospective cohort study. Setting & Participants We used data from the Patient Outcomes in Renal Transplantation (PORT) Study, including 13,671 transplants from 12 centers during 10 years of follow-up. Predictor Estimated glomerular filtration rate (eGFR; in milliliters per minute per 1.73 m2 ) at 12 months posttransplant. Outcomes All-cause graft failure (a composite end point consisting of return to dialysis therapy, pre-emptive retransplant, or death with function), death-censored graft failure, and death with a functioning graft. Measurements The relationship between 12-month eGFR and subsequent graft outcomes through 10 years posttransplant was assessed using Cox proportional hazards analyses. Results Stage 3 included 63% of patients and was subdivided into stages 3a (eGFR, 45-59 mL/min/1.73 m2 ; 34%) and 3b (eGFR, 30-44 mL/min/1.73 m2 ; 29%). Compared with stage 2 (eGFR, 60-89 mL/min/1.73 m2 ; 24%), adjusted Cox proportional HRs for graft failure were 1.12 (95% CI, 1.01-1.24; P = 0.04) for stage 3a, 1.50 (95% CI, 1.35-1.66; P < 0.001) for stage 3b, 2.86 (95% CI, 2.53-3.22; P < 0.001) for stage 4 (eGFR, 15-29 mL/min/1.73 m2 ; 9%), and 13.2 (95% CI, 10.7-16.4; P < 0.001) for stage 5 (eGFR <15 mL/min/1.73 m2 ; 1%). For stage 1 (eGFR ≥90 mL/min/1.73 m2 ; 3%), risk of graft failure was increased (1.41 [95% CI, 1.13-1.75]; P < 0.001), likely due to serum creatinine associations independent of kidney function. Similar associations were seen between CKD stages and mortality. Limitations Retrospective study; lack of gold-standard measurements of true GFR; lack of measures of comorbidity, inflammation, muscle mass, proteinuria, and other noncreatinine markers of eGFR. Conclusions CKD stages validated in the general population provide a useful framework for predicting outcomes after kidney transplant.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Chronic kidney disease</subject><subject>estimated glomerular filtration rate</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>graft outcomes</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>kidney transplant</subject><subject>Kidney Transplantation</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Prognosis</subject><subject>Renal failure</subject><subject>Retrospective Studies</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>United States - epidemiology</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Young Adult</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1vEzEQhi1ERUPhD3BAviBOG8Yf6-xKCKlUtKBGQqLhiCzHnqXebrzB3g3Kv8dLUpB66MnS-HlnRs8Q8orBnEEp3rVz0965OYe_hTmU8gmZsZKLQlWiekpmwBe8UKJSp-R5Si0A1EKpZ-SUM14uuBQz8mN1i_QbdmbwfUi3fks_4vAbMdBr7wLu6eUY7PRHTXB02YefxYBxQ6-iaQZ6M8ad35mOnje5eh9ZRRPStjNheEFOGtMlfHl8z8j3y0-ri8_F8uvVl4vzZWGlhKGoSgGCLdaMowPOgRvDVAMGVGUsXzPL3FpVFrizDRp0bCFBWsUaLJ2oGynOyNtD323sf42YBr3xyWKXd8B-TDoP4JyXUmSSH0gb-5QiNnob_cbEvWagJ6u61ZNVPVmdatlqDr0-th_XG3T_IvcaM_DmCJhkTddkAdan_5yoRa0ky9z7A4dZxs5j1Ml6DBadj2gH7Xr_-B4fHsRt54PPE-9wj6ntxxiyZs104hr0zXT_6fwMgClV1eIPgU-qOQ</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Kasiske, Bertram L., MD</creator><creator>Israni, Ajay K., MD, MS</creator><creator>Snyder, Jon J., PhD, MS</creator><creator>Skeans, Melissa A., MS</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>The Relationship Between Kidney Function and Long-term Graft Survival After Kidney Transplant</title><author>Kasiske, Bertram L., MD ; Israni, Ajay K., MD, MS ; Snyder, Jon J., PhD, MS ; Skeans, Melissa A., MS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-8530317b12ed02202aa16f0a068ac2b1c1db68c02dcfeaed17404c61fe5d39f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Chronic kidney disease</topic><topic>estimated glomerular filtration rate</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>graft outcomes</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>kidney transplant</topic><topic>Kidney Transplantation</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Prognosis</topic><topic>Renal failure</topic><topic>Retrospective Studies</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>United States - epidemiology</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kasiske, Bertram L., MD</creatorcontrib><creatorcontrib>Israni, Ajay K., MD, MS</creatorcontrib><creatorcontrib>Snyder, Jon J., PhD, MS</creatorcontrib><creatorcontrib>Skeans, Melissa A., MS</creatorcontrib><creatorcontrib>Patient Outcomes in Renal Transplantation (PORT) Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kasiske, Bertram L., MD</au><au>Israni, Ajay K., MD, MS</au><au>Snyder, Jon J., PhD, MS</au><au>Skeans, Melissa A., MS</au><aucorp>Patient Outcomes in Renal Transplantation (PORT) Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Relationship Between Kidney Function and Long-term Graft Survival After Kidney Transplant</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>57</volume><issue>3</issue><spage>466</spage><epage>475</epage><pages>466-475</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract><![CDATA[Background Whether chronic kidney disease (CKD) staging provides a useful framework for predicting outcomes after kidney transplant is unclear. Study Design Retrospective cohort study. Setting & Participants We used data from the Patient Outcomes in Renal Transplantation (PORT) Study, including 13,671 transplants from 12 centers during 10 years of follow-up. Predictor Estimated glomerular filtration rate (eGFR; in milliliters per minute per 1.73 m2 ) at 12 months posttransplant. Outcomes All-cause graft failure (a composite end point consisting of return to dialysis therapy, pre-emptive retransplant, or death with function), death-censored graft failure, and death with a functioning graft. Measurements The relationship between 12-month eGFR and subsequent graft outcomes through 10 years posttransplant was assessed using Cox proportional hazards analyses. Results Stage 3 included 63% of patients and was subdivided into stages 3a (eGFR, 45-59 mL/min/1.73 m2 ; 34%) and 3b (eGFR, 30-44 mL/min/1.73 m2 ; 29%). Compared with stage 2 (eGFR, 60-89 mL/min/1.73 m2 ; 24%), adjusted Cox proportional HRs for graft failure were 1.12 (95% CI, 1.01-1.24; P = 0.04) for stage 3a, 1.50 (95% CI, 1.35-1.66; P < 0.001) for stage 3b, 2.86 (95% CI, 2.53-3.22; P < 0.001) for stage 4 (eGFR, 15-29 mL/min/1.73 m2 ; 9%), and 13.2 (95% CI, 10.7-16.4; P < 0.001) for stage 5 (eGFR <15 mL/min/1.73 m2 ; 1%). For stage 1 (eGFR ≥90 mL/min/1.73 m2 ; 3%), risk of graft failure was increased (1.41 [95% CI, 1.13-1.75]; P < 0.001), likely due to serum creatinine associations independent of kidney function. Similar associations were seen between CKD stages and mortality. Limitations Retrospective study; lack of gold-standard measurements of true GFR; lack of measures of comorbidity, inflammation, muscle mass, proteinuria, and other noncreatinine markers of eGFR. Conclusions CKD stages validated in the general population provide a useful framework for predicting outcomes after kidney transplant.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21257243</pmid><doi>10.1053/j.ajkd.2010.10.054</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Chronic kidney disease estimated glomerular filtration rate Female Follow-Up Studies Glomerular Filtration Rate - physiology graft outcomes Graft Rejection - epidemiology Graft Survival Humans Incidence Kidney Failure, Chronic - surgery kidney transplant Kidney Transplantation Kidneys Male Medical sciences Middle Aged Nephrology Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Prognosis Renal failure Retrospective Studies Survival Rate - trends Time Factors United States - epidemiology Urinary system involvement in other diseases. Miscellaneous Young Adult |
| title | The Relationship Between Kidney Function and Long-term Graft Survival After Kidney Transplant |
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