Patients Returning to Dialysis after Failed Kidney Transplant: How Do They Fare? A Gulf Perspective

• 作者: Abdelkarim Saleh Ahmed Chaaban Fares Chedid Mohamed Osman Mohammad Budruddin Muna Rukhaimi Naveed Haq Nicole Gebran Osman Furaih Qutaiba Hussain Samra Abouchacra Suad Sajwani
• 来源期刊: 内科学期刊(英文)
• 学科: 医学
• 关键词: RENAL TRANSPLANT Graft NEPHRECTOMY Hemodialysis DIALYSIS Transplant-Naive PATIENTS End Stage RENAL Disease ESRD
• 年，卷（期）: 2014,（3）
• 页码范围: 82-86
• 页数: 5页
• 分类号: R73

摘要

An increasing number of failed transplant patients returning to dialysis (FTRD) have been observed with reported worse survival compared to transplant-naive dialysis (TxN) patients. This study aimed to assess outcomes of FTRD vs. matched TxN controls in a Gulf region multi-center trial of 800 HD patients. Similar mortality was seen, likely due to earlier start and better HD adequacy in FTRD. Younger age, less diabetes and living donor transplantation in majority with 27% graft nephrectomy (Nx) might also confer benefits. Subgroup analysis of Nx patients showed more hospitalizations and prior rejection episodes with lower graft survival. The deaths, however, oc-curred only in nonNx group and are likely explained by older age, longer duration on HD, more prevalence of diabetes and CAD. FTRD showed similar survival to TxN. Early intensive HD might account for the benefit. Whether Nx confers advantage is unclear because of the small sample size.