Impact of diabetes and chronic dialysis on post‐transplant survival in combined heart‐kidney transplant recipients
Autor: | Harrison S Chau, Jennifer Berumen, Gabriel T. Schnickel, Kristin L. Mekeel, Justin R. Parekh, Jenny Lam |
---|---|
Rok vydání: | 2021 |
Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Population Disease Kidney Renal Dialysis Diabetes mellitus Internal medicine Diabetes Mellitus Humans Medicine Registries education Kidney transplantation Dialysis Transplantation education.field_of_study business.industry Vascular disease Proportional hazards model Graft Survival medicine.disease Kidney Transplantation Transplant Recipients Kidney Failure Chronic business Kidney disease |
Zdroj: | Clinical Transplantation. 35 |
ISSN: | 1399-0012 0902-0063 |
Popis: | Growing research supports an increased survival benefit of combined heart and kidney transplantation in patients with both heart and renal failure. As a result, the frequency of these combined transplants continues to increase. Despite this trend, little has been done to quantify the impact of chronic illness in this population. We identified adult recipients of combined heart-kidney transplant from the Scientific Registry of Transplant Recipients (SRTR) database between 2005 and 2018. We focused on renal disease secondary to diabetes and duration of dialysis as markers of chronic illness. The primary outcome was post-transplant mortality. Our final multivariable Cox proportional hazard model found that diabetes-associated renal disease (HR 1.57, 95% CI 1.14-2.15, p = .01) and dialysis duration (HR 1.08, 95% CI 1.01-1.15, p = .02) were significant predictors of post-transplant mortality. Given the significant impact of dialysis duration and renal disease secondary to diabetes mellitus, these chronically ill patients should be closely examined for conditions such as peripheral vascular disease and frailty, which have been shown to affect mortality in heart transplant recipients and are prevalent in the chronic dialysis population. |
Databáze: | OpenAIRE |
Externí odkaz: |