Details

Autor(en) / Beteiligte

• Tada, M
• Hasegawa, M
• Sasaki, H
• Kusaka, M
• Shiroki, R
• Hoshinaga, K
• Ito, T
• Kenmochi, T
• Nakai, S
• Takahashi, K
• Hayashi, H
• Koide, S
• Yuzawa, Y

Titel

Kidney Transplantation, Cardiovascular Risk, and Long-Term Dialysis in Japan

Ist Teil von

• Transplantation proceedings, 2016-01, Vol.48 (1), p.26-30

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Abstract Background The waiting time for deceased-donor kidney-only transplantations in Japan is long. Herein, we assessed the effect of length of dialysis on the outcomes of these patients. Methods We divided patients into 2 groups based on length of dialysis (Group A, <15 years, and Group B, ≥15 years), and compared the background and outcomes after kidney transplantation. Results Group A included 210 patients and Group B included 35 patients. In Group B, 20% of transplants were from living donors. Patient age ( P  = .017) and the hepatitis C infection rate ( P  = .018) were significantly higher in Group B, whereas hypertension ( P  = .011), diabetes ( P  = .041), and ABO-incompatibility rates ( P  = .015) were significantly higher in Group A. The 5- and 10-year survival rates were 97.0% and 95.4%, respectively, in Group A and 97.1% and 97.1%, respectively, in Group B. The 5- and 10-year graft survival rates were 95.4% and 84.8%, respectively, in Group A and 97.1% and 73.1%, respectively, in Group B. There were no significant differences between the groups in patient survival ( P  = .74) and graft survival ( P  = .72). The 5- and 10-year cardiovascular event-free survival rates were 95.9% and 92.4%, respectively, in Group A and 88.6% and 76.8%, respectively, in Group B. Cardiovascular event-free survival was significantly higher in Group A ( P  = .038). Cox stepwise multivariate analysis indicated that length of dialysis was a significant predictor of cardiovascular events (hazard risk, 1.007; range, 1.001–1.012; P  = .012). Conclusion The prognosis after kidney transplantation is promising even after a long length of dialysis, although evaluation of the cardiovascular risk is needed in these cases.