NDLI: Comparison of Patient Outcome According to Renal Replacement Modality after Renal Allograft Failure

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Comparison of Patient Outcome According to Renal Replacement Modality after Renal Allograft Failure

Content Provider	Taylor & Francis Online
Author	Choi, Sun Ryoung Sun, In O. Moon, In Sung Park, Joo Hyun Park, Cheol Whee Shin, Young Shin Kim, Ji-Il Chung, Byung Ha Kim, Yong-Soo Kang, Seok Hui Choi, Bum Soon Park, Hoon Suk Yang, Chul Woo Lee, Ja Young
Abstract	The aim of this study is to investigate the clinical course of patients with failed allograft according to the type of renal replacement modality. Three hundred sixty-eight patients with failed allograft were included. Of these, 233 patients started hemodialysis (HD-PSKT), 64 patients started peritoneal dialysis (PD-PSKT), and 71 patients underwent second transplantation (ReKT). At baseline, age, sex, laboratory findings, and comorbidity did not differ significantly among three groups. Chronic rejection was the most common cause of allograft failure (81.6%) followed by acute rejection (10.7%). During the observation period, 96 patients died. The most common cause of death was cardiovascular disease (39.6%) followed by infection (34.4%) and malignancy (8.3%). Infection was important cause of death within 10 years from allograft failure, but cardiovascular disease and malignancy occupied significant portion of death after 10 years from allograft failure. Significant difference was not found among the three groups in the cause of allograft failure and the cause of death. The patient outcome was better in the ReKT than in the other two groups and it did not differ significantly between the PD-PSKT and HD-PSKT. In multivariate analysis, old age, hypoalbuminemia, and high comorbidity were proved to be the independent risk factors for mortality and the ReKT was still significantly superior to the HD-PSKT and PD-PSKT after adjustment for other confounding factors. In conclusion, second transplantation may result in survival benefit, and proper management of nutrition and comorbidity may help to improve outcome in patients with failed allograft.
Starting Page	261
Ending Page	268
Page Count	8
File Format	PDF HTM / HTML
ISSN	0886022X 15256049
DOI	10.3109/0886022X.2011.559678
Journal	Renal Failure
Volume Number	33
Issue Number	3
Language	English
Publisher	Taylor & Francis
Publisher Date	2011-03-14
Access Restriction	Open
Subject Keyword	Hemodialysis Allograft failure Kidney transplantation Peritoneal dialysis
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine Nephrology

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