Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/17117
Citations | ||
Scopus | Web of ScienceĀ® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Effect of previously failed kidney transplantation on peritoneal dialysis outcomes in the Australian and New Zealand patient populations |
Author: | Badva, S. Hawley, C. McDonald, S. Mudge, D. Rosman, J. Brown, F. Johnson, D. |
Citation: | Nephrology Dialysis Transplantation, 2006; 21(3):776-783 |
Publisher: | Oxford Univ Press |
Issue Date: | 2006 |
ISSN: | 0931-0509 1460-2385 |
Abstract: | <h4>Background</h4>There is limited information about the outcomes of patients commencing peritoneal dialysis (PD) after failed kidney transplantation. The aim of the present study was to compare patient survival, death-censored technique survival and peritonitis-free survival between patients initiating PD after failed renal allografts and those after failed native kidneys.<h4>Methods</h4>The study included all patients from the ANZDATA Registry who started PD between April 1, 1991 and March 31, 2004. Times to death, death-censored technique failure and first peritonitis episode were examined by multivariate Cox proportional hazards models. For all outcomes, conditional risk set models were utilized for the multiple failure data, and analyses were stratified by failure order. Standard errors were calculated by using robust variance estimation for the cluster-correlated data.<h4>Results</h4>In total, 13,947 episodes of PD were recorded in 23,579 person-years. Of these, 309 PD episodes were started after allograft failure. Compared with PD patients who had never undergone kidney transplantation, those with failed renal allografts were more likely to be younger, Caucasian, New Zealand residents and life-long non-smokers with lower body mass index (BMI), poorer initial renal function and a longer period from commencement of the first renal replacement therapy to PD. On multivariate analysis, PD patients with failed kidney transplants had comparable patient mortality [weighted hazards ratio (HR) 1.09, 95% confidence interval (CI) 0.81-1.45, P = 0.582], death-censored technique failure (adjusted HR 0.91, 95% CI 0.75-1.10, P = 0.315) and peritonitis-free survival (adjusted HR 0.92, 95% CI 0.72-1.16, P = 0.444) with those PD patients who had failed native kidneys. Similar findings were observed in a subset of patients (n = 5496) for whom peritoneal transport status was known and included in the models as a covariate.<h4>Conclusion</h4>Patients commencing PD after renal allograft failure experienced outcomes comparable with those with failed native kidneys. PD appears to be a viable option for patients with failed kidney allografts. |
Keywords: | ANZDATA Registry PD Working Committee Humans Kidney Failure, Chronic Disease-Free Survival Treatment Failure Peritoneal Dialysis Kidney Transplantation Population Surveillance Survival Rate Retrospective Studies Follow-Up Studies Adult Middle Aged Australia New Zealand Female Male |
DOI: | 10.1093/ndt/gfi248 |
Published version: | http://dx.doi.org/10.1093/ndt/gfi248 |
Appears in Collections: | Aurora harvest 6 Public Health publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.