CKD complications in kidney-transplanted patients going back to dialysis: impact on patients outcomes.

Abstract:

AIMS:The management of chronic kidney disease (CKD) complications is not always adequate in patients with a failed kidney transplant. We aimed to evaluate the frequency of CKD complications and assess whether they may lead to worse outcomes in this patient population. METHOD:We analyzed 49 kidney transplant recipients with a failed transplant (T+) and matched non-transplanted patients (T-) starting dialysis between 2000 and 2010 in five dialysis centers in France. CKD complications at dialysis initiation, hospitalizations and death were recorded and compared between the two groups. RESULTS:At dialysis initiation, T+ patients were more likely to have bicarbonate < 22 mmol/l (77.6 vs. 22.0%, p < 0.01), phosphate > 1.5 mmol/l (77.6 vs. 59.2%, p = 0.03), arterial blood pressure > 130/80 mmHg (75.5 vs. 93.9%, p = 0.01), body mass index < 23 (59.2 vs. 32.7%, p = 0.01) and albumin < 38 g/l (69.4 vs. 36.7%) than T- patients. T+ patients were hospitalized more frequently in the year following dialysis initiation (40.8 ± 7.0 vs. 16.3 ± 5.3%, log rank p = 0.01) and 5-year survival rate was lower than in T- patients (82.1 ± 6.2 vs. 64.0 ± 7.4%, log rank p = 0.02). However risk of hospitalization and mortality was lesser after adjustments for CKD complications. CONCLUSION:Despite regular follow-up by nephrologists, CKD complications before initiation of dialysis are more frequent in T+ patients than in T- patients. A better management of CKD complications in T+ patients could improve outcomes after dialysis initiation.

journal_name

J Nephrol

journal_title

Journal of nephrology

authors

Aniort J,Kaysi S,Garrouste C,Abdelkader MH,Isnard M,Aguilera D,Ali Y,Bouiller M,Mulliez A,Heng AE

doi

10.1007/s40620-017-0449-z

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

147-155

issue

1

eissn

1121-8428

issn

1724-6059

pii

10.1007/s40620-017-0449-z

journal_volume

31

pub_type

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