Survival analysis and associated factors to mortality of renal transplant recipients in a University Hospital in Maranhão

Oliveira, Mário Norberto Sevílio de; Santos, Alcione Miranda dos; Filho, Natalino Salgado

doi:10.5935/0101-2800.20120002

Cited by 16 publications

(11 citation statements)

References 31 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Undoubtedly, the difference reflects the health situation in the developed and developing countries. There is evidence in the previous studies that the recipient age more than 40 years is considered a prognostic factor of higher risk of mortality in RT patients [9]. The causes of end-stage kidney disease (ESKD) observed in this study are chronic pyelonephritis (77.9%), hypertension (13%), diabetes mellitus (2.9%) and chronic glomerulonephritis (2.6%).…”

Section: Discussionmentioning

confidence: 52%

The Experience and Outcome of Renal Transplantation in Yemen

Abu-Asba¹,

Nono²,

Badani³

et al. 2019

IJCU

View full text Add to dashboard Cite

Access to renal transplantation in the developing world remains limited It remains the treatment of choice for endstage kidney disease. This procedure not only improves quality of life, but also markedly increases patients' survival rates. Therefore, this study aimed to evaluate clinical outcomes of renal transplants in our center and to compare the outcomes between the patients who received induction therapy and those patients without such induction. It was a retrospective study conducted at Al Thawra General Hospital, Sana'a on 154 patients. Data were collected on all patients who underwent a renal transplant from 2004 to t 2015. Analyses were performed to assess baseline characteristics, graft and patient survival, as well as the outcomes of patients who given induction therapy. A total of 154 renal transplants were carried out at Al Thawra center. The mean age of patients was 32.42 ± 10.4 years (rang 14-66) and the male sex was predominant accounting for 72.7%. There were 93.5% of patients on dialysis and the dialysis time was ≥ 3 years in 72%. The major causes of end-stage kidney disease (ESKD) were chronic pyelonephritis (77.9%), hypertension (13%), glomerulonephritis (3.9%) and diabetes mellitus (2.4%). During the first year following renal transplants, 6 patients (3.9%) complicated by acute rejection episodes that did not reach statistical significance (P > 0.05). It is found that the mortality rate during the 1 st , 5 th , and 10 th years was 1.9%, 9% and 14.9%respectively and the infectious conditions were the most frequent cause of death (13%) followed by cardiovascular events (3.9%) and others (2.5%). Although, the process of renal transplants in Yemen started slowly with the initial support and cooperation of the Egyptians' transplant surgeons, the overall outcomes are satisfactory and comparable to the universal reports.

show abstract

Section: Discussionmentioning

confidence: 52%

The Experience and Outcome of Renal Transplantation in Yemen

Abu-Asba¹,

Nono²,

Badani³

et al. 2019

IJCU

View full text Add to dashboard Cite

show abstract

“…However, among participants with a known cause of death, the majority died of sepsis (64%) which is consistent with studies done in Brazil and sub-Saharan Africa. 46,47 This is likely to have obscured any difference attributable to cardiovascular causes.…”

Section: Discussionmentioning

confidence: 99%

The impact of vascular calcification among dialysis dependent south African CKD patients: A five year follow up study.Cardiovascular mortality and morbidity, ethnic variation and hemodynamic correlates

Simba¹,

Borkum²,

Strauss³

et al. 2019

Preprint

View full text Add to dashboard Cite

BACKGROUND Vascular calcification is a risk factor for cardiovascular morbidity and mortality in patients with end stage renal disease (ESRD). In Western countries, Blacks with ESRD appear to have lesser degrees of vascular calcification compared to non-Blacks. However, there is no published data on the association of ethnic differences in vascular calcification and survival in ESRD from Sub-Saharan Africa. METHODS This study assessed 5-year changes in vascular calcification and mortality in a previously published cohort of patients with ESRD. Vascular calcification was assessed by abdominal aortic calcification score and vascular stiffness by pulse wave velocity. RESULTS Sixty-six of the original 74 participants, studied at baseline, were identified. The median age was 46.6 years (37.6-59.2) and 57.6% were women. Abdominal aortic calcification showed no progression among Blacks [baseline range 0-5, follow up range 0-8 (p=1.00)], but a non-significant trend to progression among non-Blacks [baseline range 0-19, follow up range 0-22 (p=0.066)]. Black participants did not display a survival advantage (p=0.870). Overall, sepsis was the most common cause of mortality (64% of those with an identifiable cause of death). Non-Blacks had higher parathyroidectomy rates than Blacks with 9/30 cases compared to 2/36 (p=0.036). After adjustment for parathyroidectomy at follow up, the odds ratio of having abdominal vascular calcification score of ≥1 amongst non-Blacks was 8.6-fold greater compared to Blacks (p= 0.03). Central aortic systolic pressures (CASP) and pulse wave velocities (PWV) were higher in the study population than age matched normative values. At follow up, a positive correlation (r=0.5) was observed between PWV and abdominal aortic calcification (p=0.047). Elevated baseline coronary artery calcification score and FGF-23 level at baseline were not associated with a difference in mortality. CONCLUSION There was no significant progression in vascular calcification among Blacks. After adjusting for increased parathyroidectomy rates, there was a greater progression of vascular calcification amongst non-Blacks compared to Blacks highlighting possible ethnic differences in calcium phosphate metabolism in patients with ESRD. Lack of vascular calcification progression in Blacks was not associated with improved survival, but the sample size was small.

show abstract

“…Yet, in developing countries, the leading cause of death following renal transplant is infectious, followed by cardiovascular. 16 - 18 The low incidence of death due to malignancy is perhaps associated with the still limited follow-up time of 5 years.…”

Section: Discussionmentioning

confidence: 99%