Clinical impact of early graft function in kidney transplant recipients on long-term dialysis: A retrospective cohort study

Table 1 Pre-transplant clinical characteristics, median (25^th-75^th percentiles)

Variables	Group LTD (n = 28)	Group STD (n = 227)	P value1
Age at Tx (years)	51 (45-55)	46 (36-57)	0.123
Male gender (%)	57.1	60.8	0.838
BMI at Tx (kg/m2)	20.52 (18.87- 21.91)	21.85 (19.41- 24.83)	0.086
Dialysis duration (years)	20.2 (17.2-24.3)	1.4 (0.5-4.9)	< 0.001
Comorbidity at Tx
Hypertension (%)	59.3	82.8	0.008
Diabetes mellitus (%)	0	19.8	0.006
Dyslipidemia (%)	17.2	7.4	0.271
History of CVD event (%)	24.0	14.2	0.236
Cause of ESKD
CGN (%)	75.0	21.6	< 0.001
ADPKD (%)	3.6	8.4	0.707
IgA nephropathy (%)	3.6	13.7	0.221
Diabetic kidney disease (%)	0	19.4	0.006
Other or unknown (%)	17.9	33.9	0.132
Deceased donor kidney Tx (%)	85.7	2.2	< 0.001
Donor age at Tx (years)	57 (44-62)	58 (51-65)	0.119
Donor male gender (%)	60.7	37.0	0.023
ABO-incompatible (%)	3.6	26.0	0.008
HLA mismatch number	3 (2-3)	3 (3-5)	0.007

¹P values were calculated using the Mann-Whitney U test for continuous variables and the χ² test for categorical variables.

Tx: Transplantation; BMI: Body mass index; CVD: Cardiovascular disease; ESKD: End-stage kidney disease; CGN: Chronic glomerulonephritis; ADPKD: Autosomal dominant polycystic kidney disease; HLA: Human leukocyte antigen; LTD: Long-term dialysis; STD: Short-term dialysis.

Table 2 Post-transplant clinical characteristics, median (25^th-75^th percentiles)

Variables	Group LTD (n = 28)	Group STD (n = 227)	P value1
Immunosuppression
Methylprednisolone (%)	96.4	94.3	1
Tacrolimus (%)	53.6	44.5	0.423
Cyclosporine (%)	46.4	55.5	0.423
Mycophenolate mofetil (%)	96.4	89.0	0.328
Mizoribine (%)	0	3.1	1
Everolimus (%)	3.6	7.9	0.704
Outcomes
Best S-Cr (mg/dL)	1.37 (1.18-2.04)	1.33 (1.02-1.55)	0.102
Acute rejection (%)	21.4	23.8	1
CMV infection (%)	42.9	25.1	0.069
Surgical complications (%)	14.3	15.0	1
Hypertension (%)	85.7	83.3	1
Diabetes mellitus (%)	14.3	27.8	0.172
Dyslipidemia (%)	46.4	59.4	0.225
Malignancy (%)	17.9	4.8	0.021
CVD event (%)	10.7	6.6	0.429

¹P values were calculated using the Mann-Whitney U test for continuous variables and the χ² test for categorical variables.

Best S-Cr: Lowest serum creatinine level within 3 months of transplantation; CMV: Cytomegalovirus; CVD: Cardiovascular disease; LTD: Long-term dialysis; STD: Short-term dialysis.

Table 3 Details of deaths in transplant recipients

Case	Age (years)	Gender	Time from Tx to death (years)	Dialysis duration (years)	Best S-Cr (mg/dL)	Causes of death
Group LTD
1	52	Male	2.1	30.0	PNF	Sepsis
2	53	Male	0.5	25.1	2.86	Renal cell carcinoma
3	65	Female	11.5	18.8	0.77	Sepsis
4	40	Male	1.5	15.5	4.28	Varicella zoster
5	54	Male	0.6	15.3	3.67	Cardiovascular disease
6	55	Female	8.6	15.0	1.28	Sepsis
Group STD
1	40	Male	3.1	13.2	2.19	Alcoholic pancreatitis
2	59	Male	2.0	10.3	PNF	Cardiovascular disease
3	71	Male	6.9	8.2	0.83	Bacterial pneumonia
4	65	Male	1.7	3.7	1.9	Pancreatic carcinoma
5	74	Male	4.2	3.3	2.04	Cardiovascular disease
6	56	Male	11.2	2.0	2.13	Cardiovascular disease
7	54	Female	13.3	1.0	1.03	Myelodysplastic syndrome
8	62	Male	5.8	0.9	0.82	Cardiovascular disease
9	77	Male	5.0	0	1.16	Gastric carcinoma
10	72	Female	6.3	0	0.84	Cardiovascular disease

PNF: Primary non function; Tx: Transplantation; Best S-Cr: Lowest serum creatinine level within 3 months of transplantation; LTD: Long-term dialysis; STD: Short-term dialysis.

Table 4 Univariate and multivariate Cox regression analysis of risk factors associated with death after transplantation¹

Variables	Factors	Univariate analysis			Multivariate analysis
		HR	95%CI	P value	HR	95%CI	P value
Age (years)	Increase of 1 year	1.069	1.022-1.118	0.003	1.058	1.002-1.116	0.040
Gender	Male vs female	2.087	0.673-6.475	0.203	-
Donor gender	Male vs female	1.171	0.436-3.146	0.755
BMI (kg/m2)	Increase of 1 kg/m2	0.993	0.864-1.142	0.927	-
Dialysis duration (years)	Increase of 1 year	1.076	1.021-1.134	0.006	NE
Pre-Tx DM	Present vs absent	1.089	0.243-4.881	0.912	-
Malignancy	Present vs absent	6.139	2.170-17.369	< 0.001	NE
Post-Tx CVD	Present vs absent	17.775	6.421-49.206	< 0.001	20.264	6.052-67.850	< 0.001
Best S-Cr (mg/dL)	Increase of 1 mg/dL	2.949	1.704-5.104	< 0.001	4.155	2.234-7.730	< 0.001

¹Multivariate analysis was performed using the Cox multivariate proportional hazard regression model with stepwise method (forward, likelihood ratio).

HR: Hazard ratio; BMI: Body mass index; pre-Tx DM: Pre-transplant diabetes mellitus; post-Tx CVD: Post-transplant history of cardiovascular disease; Best S-Cr: Lowest serum creatinine level within 3 months of transplantation; NE: Not entered.