BACKGROUND: Impact of kidney transplantation on survival of French end-stage renal disease (ESRD) patients is unknown. METHODS: A total of 1495 adults living in the Lorraine region and starting renal replacement therapy from 1997 to 2003 were included. A propensity score (PS) of registration on the renal transplant waiting list was estimated. Patient survival was studied using a time-dependent Cox multivariate regression and a Cox model stratified by PS tertiles. Survival of older patients (> or =60 years) was detailed. RESULTS: Survival was associated with age, medical factors and transplantation. The hazard ratio (HR) of death for patients on dialysis compared to transplant recipients was 4.6 (95% CI: 2.9-7.2). The survival analysis stratified by PS was similar to the multivariate Cox model. The survival benefit of transplantation over dialysis persisted among elderly patients [HR: 4.6 (95% CI: 2.2-9.7)]. CONCLUSIONS: In a French community-based network, after taking into account comorbidities, transplantation was associated with longer survival even among elderly patients. Age per se should not therefore be considered as a contraindication to renal transplantation. However, elderly patients should be evaluated carefully before registration on the list. Medical guidelines should put forward a standard set of criteria for access to renal transplantation.
BACKGROUND: Impact of kidney transplantation on survival of French end-stage renal disease (ESRD) patients is unknown. METHODS: A total of 1495 adults living in the Lorraine region and starting renal replacement therapy from 1997 to 2003 were included. A propensity score (PS) of registration on the renal transplant waiting list was estimated. Patient survival was studied using a time-dependent Cox multivariate regression and a Cox model stratified by PS tertiles. Survival of older patients (> or =60 years) was detailed. RESULTS: Survival was associated with age, medical factors and transplantation. The hazard ratio (HR) of death for patients on dialysis compared to transplant recipients was 4.6 (95% CI: 2.9-7.2). The survival analysis stratified by PS was similar to the multivariate Cox model. The survival benefit of transplantation over dialysis persisted among elderly patients [HR: 4.6 (95% CI: 2.2-9.7)]. CONCLUSIONS: In a French community-based network, after taking into account comorbidities, transplantation was associated with longer survival even among elderly patients. Age per se should not therefore be considered as a contraindication to renal transplantation. However, elderly patients should be evaluated carefully before registration on the list. Medical guidelines should put forward a standard set of criteria for access to renal transplantation.
Authors: Jesse D Schold; Laura D Buccini; David A Goldfarb; Stuart M Flechner; Emilio D Poggio; Ashwini R Sehgal Journal: Clin J Am Soc Nephrol Date: 2014-09-18 Impact factor: 8.237
Authors: Farah Tasnim; Rensheng Deng; Min Hu; Sean Liour; Yao Li; Ming Ni; Jackie Y Ying; Daniele Zink Journal: Fibrogenesis Tissue Repair Date: 2010-08-10
Authors: Austin D Schenk; April J Logan; Jeffrey M Sneddon; Daria Faulkner; Jing L Han; Guy N Brock; William K Washburn Journal: J Am Coll Surg Date: 2022-06-17 Impact factor: 6.532