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Reduced survival in patients who return to dialysis after kidney allograft failure
Author(s) -
Bisigniano Liliana,
Laham Gustavo,
Giordani Maria Cora,
Tagliafichi Viviana,
Hansen Krogh Daniela,
Maceira Alberto,
RosaDiez Guillermo Javier
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14014
Subject(s) - medicine , contraindication , dialysis , proportional hazards model , hazard ratio , kidney transplantation , survival analysis , gastroenterology , surgery , kidney , confidence interval , pathology , alternative medicine
Background The outcome of patients who return to dialysis after Kidney allograft failure (KAF) remains unclear. Our aim was to compare the outcome of KAF patients vs two different types of transplant naive incident dialysis (TNID) patients, those on the waiting list (WL) and those with a kidney transplant contraindication (KTC). Methods We performed an observational study using data from the Argentinian Dialysis Registry between 2005 and 2016. We compare mortality between KAF, WL, and KTC. Results We included 75 722 patients of which 2734 were KAF. Survival between the three cohorts (KAF vs WL (n = 14 630) vs KTC (n = 58 358) revealed a significant difference (log‐rank test: P < .0001) indicating worse survival for KTC patients and best survival for WL. We found that KAF patients had as poor outcome as KTC patients after multivariate adjustment. Cox regression showed that age >65 years: HR: 1.845 (1.79‐1.89) P < .0001, transient catheter: HR: 1.303 (1.26‐1.34) P < .0001, diabetic: HR: 1.273 (1.22‐1.31) P < .0001, hepatitis C: HR: 1.156 (1.09‐1.22) P < .0001, and albumin: HR: 1.247 (1.21‐1.28) P < .0001 were associated with mortality. Conclusion Patients who return to dialysis after KAF have higher mortality than WL patients and similar to KTC patients.