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High mortality in the first year after kidney graft failure
J Buturović-Ponikvar1, J Gubensek, M Arnol
1Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia. jadranka.buturovic@mf.uni-Ij.si
Transplantation Proceedings
|June 4, 2013
Summary
Patients restarting dialysis after kidney graft failure face higher early mortality. Survival improves significantly after the first year, highlighting the critical need for close monitoring post-transplant. Kidney graft failure survival rates are lower.
Area of Science:
- Nephrology
- Transplantation Medicine
- Public Health
Background:
- Kidney graft failure necessitates renal replacement therapy, impacting patient survival.
- Assessing long-term outcomes after kidney transplantation is crucial for patient management.
Purpose of the Study:
- To evaluate the survival rates of patients following kidney graft failure and subsequent initiation of dialysis.
- To compare survival between patients starting dialysis post-graft failure and incident dialysis candidates.
Main Methods:
- A cohort study identified 82 patients starting dialysis post-graft failure from the Slovenian Renal Replacement Therapy Registry (2004-2010).
- Survival data were analyzed, comparing the cohort to 351 incident dialysis patients (transplant candidates) until December 31, 2011.
- Retransplantation was not a censoring event in survival analysis.
Main Results:
- Patients restarting dialysis after graft failure had significantly lower 1- and 3-year survival rates (70% and 68%) compared to controls (98% and 93%).
- Mortality causes included infection (33%), cardiovascular disease (13%), and malignancy (9%).
- Older age and male sex were associated with increased mortality post-graft failure.
Conclusions:
- Kidney graft failure leads to increased mortality, particularly within the first year of restarting dialysis.
- Patients surviving the initial year post-graft failure demonstrate improved long-term survival.
- Close monitoring and management are essential during the early period after kidney graft failure.
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