NDT Advance Access originally published online on December 15, 2006
Nephrology Dialysis Transplantation 2007 22(3):891-898; doi:10.1093/ndt/gfl689
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The association between recipient alcohol dependency and long-term graft and recipient survival
1Department of Biomedical Informatics, University of Utah, 2Division of Nephrology and Hypertension, University of Utah School of Medicine, Salt Lake City, UT, 3Department of Internal Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA, 4Tel Aviv University, Tel Aviv, Israel, 5Division of Undergraduate Studies and University Writing Program, University of Utah and 6Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
Correspondence and offprint requests to: Alexander S. Goldfarb-Rumyantzev, MD, PhD, Division of Nephrology and Hypertension, University of Utah Health Sciences Center, 85 North Medical Drive, East Room 201, Salt Lake City, UT 84112, USA. Email: alex.goldfarb{at}hsc.utah.edu
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Abstract |
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Background. The causative role of alcohol consumption in renal disease is controversial, and its effect on renal graft and recipient survival has not been previously studied.
Methods. We analysed the association between pre-transplant [at the time of end-stage renal disease (ESRD) onset] alcohol dependency and renal graft and recipient survival. The United States Renal Data System (USRDS) records of kidney transplant recipients 18 years or older transplanted between 1 January 1995 and 31 December 2002 were examined. We used Kaplan–Meier analysis and Cox regression models adjusted for covariates to analyse the association between pre-transplant alcohol dependency and graft and recipient survival.
Results. In an entire study cohort of 60 523, we identified 425 patients with a history of alcohol dependency. Using Cox models, alcohol dependency was found to be associated with increased risk of death-censored graft failure [hazard ratio (HR) 1.38, P < 0.05] and increased risk of transplant recipient death (HR 1.56, P < 0.001). Subgroup analysis demonstrated an association of alcohol-dependency with recipient survival and death-censored graft survival in males (but not in females), and in both white and non-white racial subgroups.
Conclusions. We concluded that alcohol dependency at the time of ESRD onset is a risk factor for renal graft failure and recipient death.
Keywords: alcohol dependency; graft survival; kidney transplantation; outcome; prediction; public policy; recipient survival; renal transplantation
Received for publication: 21. 9.06
Accepted in revised form: 25.10.06