Association of pre-transplant dialysis duration with outcome in kidney transplant recipients: a prevalent cohort study

Abstract

Dialysis treatment prior to transplantation may contribute to premature mortality and graft loss in kidney-transplanted patients. In this prevalent cohort study (TransQol-HU Study), we analyzed the association between pre-transplant dialysis duration versus mortality and death-censored graft loss in kidney-transplanted patients. Data from 926 kidney-transplanted patients followed at a single outpatient transplant center were analyzed. Socio-demographic parameters, laboratory data, medical history, donor characteristics and information on co-morbidities were collected at baseline. Data on 5-year outcome (graft loss, mortality) were collected. In multivariate analyses, pre-transplant dialysis duration was an independent risk factor for mortality (HR(for each month increase)=1.011; 95% CI: 1.005-1.016) and also for death-censored graft loss (HR(for each month increase)=1.008; 95% CI: 1.001-1.015) after adjustment for several co-variables. In the multivariate model, patients with less than 1year (HR=0.498; 95% CI: 0.302-0.820; P=0.006) and 1-3years (HR=0.577; 95% CI: 0.371-0.899; P=0.015) of pre-transplant dialysis had significantly better survival after transplantation compared to those with more than 3years on dialysis. These findings add further strength to existing evidence about the significant association between longer pre-transplant dialysis duration and poor outcome in kidney-transplanted patients.