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Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2010

Survival of transplanted and dialysed patients in a French region with focus on outcomes in the elderly.

Résumé

BACKGROUND: Impact of kidney transplantation on survival of French end-stage renal disease (ESRD) patients is unknown. METHODS: A total of 1495 adults living in the Lorraine region and starting renal replacement therapy from 1997 to 2003 were included. A propensity score (PS) of registration on the renal transplant waiting list was estimated. Patient survival was studied using a time-dependent Cox multivariate regression and a Cox model stratified by PS tertiles. Survival of older patients (> or =60 years) was detailed. RESULTS: Survival was associated with age, medical factors and transplantation. The hazard ratio (HR) of death for patients on dialysis compared to transplant recipients was 4.6 (95% CI: 2.9-7.2). The survival analysis stratified by PS was similar to the multivariate Cox model. The survival benefit of transplantation over dialysis persisted among elderly patients [HR: 4.6 (95% CI: 2.2-9.7)]. CONCLUSIONS: In a French community-based network, after taking into account comorbidities, transplantation was associated with longer survival even among elderly patients. Age per se should not therefore be considered as a contraindication to renal transplantation. However, elderly patients should be evaluated carefully before registration on the list. Medical guidelines should put forward a standard set of criteria for access to renal transplantation.

Dates et versions

hal-00748834 , version 1 (06-11-2012)

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Citer

Sahar Bayat, Michèle Kessler, Serge Briançon, Luc Frimat. Survival of transplanted and dialysed patients in a French region with focus on outcomes in the elderly.. Nephrology Dialysis Transplantation, 2010, 25 (1), pp.292-300. ⟨10.1093/ndt/gfp469⟩. ⟨hal-00748834⟩

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