Skip Navigation



NDT Advance Access published online on November 9, 2005
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfi248
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
21/3/776    most recent
gfi248v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Badve, S. V.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Badve, S. V.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received June 27, 2005
Accepted October 5, 2005

Original Articles

Effect of previously failed kidney transplantation on peritoneal dialysis outcomes in the Australian and New Zealand patient populations

Sunil V. Badve 1, Carmel M. Hawley 1, Stephen P. McDonald 2, David W. Mudge 1, Johan B. Rosman 3, Fiona G. Brown 4, David W. Johnson 1*, and for The ANZDATA Registry PD Working Committee

1 Australia and New Zealand Dialysis and Transplant Registry, Adelaide; Department of Renal Medicine, Princess Alexandra Hospital, Brisbane
2 Australia and New Zealand Dialysis and Transplant Registry, Adelaide
3 Australia and New Zealand Dialysis and Transplant Registry, Adelaide; Renal Department, Middlemore Hospital, Otahuhu, Auckland, New Zealand
4 Australia and New Zealand Dialysis and Transplant Registry, Adelaide; Department of Nephrology, Monash Medical Centre, Clayton, Victoria, Australia

* To whom correspondence should be addressed.
David W. Johnson, E-mail: david_johnson{at}health.qld.gov.au



  Abstract

Background. 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.

Methods. 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.

Results. 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.

Conclusion. 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: failed renal allograft; patient survival; peritonitis; technique survival; transplantation; treatment modality.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.