Predictors of mortality in patients returning to dialysis after allograft loss

Abstract

BACKGROUND: Although patients requiring dialysis after graft loss are increasing, data regarding the outcomes of patients on dialysis after graft loss are limited. We investigated the characteristics and risk factors for mortality in patients reinitiating dialysis after graft loss.

METHODS: A retrospective analysis was done for 292 patients who reinitiated dialysis after graft loss between 1985 and 2006.

RESULTS: The mean glomerular filtration rate (GFR) at dialysis reinitiation was 9.1 +/- 4.6 ml/min/1.73 m(2). Cardiovascular disease was the most common cause of death during the 67.4 +/- 50.6 months of follow-up. History of diabetes (HR 4.11, p = 0.02), new-onset diabetes after transplantation (HR 1.96, p = 0.03), Charlson comorbidity index score (HR 1.66, p = 0.03), and low serum albumin levels (HR 0.42, p = 0.03) were independent risk factors for mortality. However, GFR at dialysis reinitiation was not.

CONCLUSIONS: Comorbid conditions, new-onset diabetes after transplantation, and hypoalbuminemia predicted mortality in patients who returned to dialysis after graft failure.