1. Comparison of graft and patient outcomes following kidney transplantation in extended hour and conventional haemodialysis patients.
- Author
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See EJ, Hawley CM, Cho Y, Toussaint ND, Agar JW, Pascoe EM, Lim WH, Francis RS, Collins MG, and Johnson DW
- Subjects
- Adult, Australia, Biomarkers blood, Cardiovascular Diseases etiology, Cause of Death, Creatinine blood, Delayed Graft Function mortality, Delayed Graft Function physiopathology, Delayed Graft Function therapy, Female, Glomerular Filtration Rate, Graft Rejection etiology, Graft Survival, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic mortality, Kidney Failure, Chronic physiopathology, Kidney Transplantation mortality, Male, Middle Aged, New Zealand, Registries, Renal Dialysis methods, Renal Dialysis mortality, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Delayed Graft Function etiology, Kidney Failure, Chronic therapy, Kidney Transplantation adverse effects, Renal Dialysis adverse effects
- Abstract
Aim: Differences in early graft function between kidney transplant recipients previously managed with either haemodialysis (HD) or peritoneal dialysis are well described. However, only two single-centre studies have compared graft and patient outcomes between extended hour and conventional HD patients, with conflicting results., Methods: This study compared the outcomes of all extended hour (≥24 h/week) and conventional HD patients transplanted in Australia and New Zealand between 2000 and 2014. The primary outcome was delayed graft function (DGF), defined in an ordinal manner as either a spontaneous fall in serum creatinine of less than 10% within 24 h, or the need for dialysis within 72 h following transplantation. Secondary outcomes included the requirement for dialysis within 72 h post-transplant, acute rejection, estimated glomerular filtration rate at 12 months, death-censored graft failure, all-cause and cardiovascular mortality, and a composite of graft failure and mortality., Results: A total of 4935 HD patients (378 extended hour HD, 4557 conventional HD) received a kidney transplant during the study period. Extended hour HD was associated with an increased likelihood of DGF compared with conventional HD (adjusted proportional odds ratio 1.33; 95% confidence interval 1.06-1.67). There was no significant difference between extended hour and conventional HD in terms of any of the secondary outcomes., Conclusion: Compared to conventional HD, extended hour HD was associated with DGF, although long-term graft and patient outcomes were not different., (© 2018 Asian Pacific Society of Nephrology.)
- Published
- 2019
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