Patients Returning to Dialysis after Failed Kidney Transplant: How Do They Fare? A Gulf Perspective
Patients Returning to Dialysis after Failed Kidney Transplant: How Do They Fare? A Gulf Perspective作者机构：Department of Nephrology Dubai Hospital Dubai UAE Department of Nephrology King Faisal Specialist Hospital and Research Center Riyadh KSA Department of Nephrology Sheikh Khalifa Medical City Abu Dhabi UAE Department of Nephrology Tawam Hospital Al Ain UAE
出 版 物：《Open Journal of Internal Medicine》 (内科学期刊（英文）)
年 卷 期：2014年第4卷第3期
页 面：82-86页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Renal Transplant Graft Nephrectomy Hemodialysis Dialysis Transplant-Naive Patients End Stage Renal Disease ESRD
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.
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