Kidney transplantationOutcomePreemptive Kidney Transplantation in Systemic Lupus Erythematosus
Section snippets
Methods
All patients in the United Network for Organ Sharing dataset who underwent a kidney transplant with kidney failure due to SLE were analyzed. Graft and patient survival for the preemptive and non-preemptive groups, defined by a lack of or prior exposure to dialysis, was determined by using the Kaplan-Meier and Proportional Hazards techniques, with adjustment for confounders known to impact outcomes.
Results
We identified 8001 patients who underwent a kidney transplant between October 1987 and February 2009 with kidney failure due to SLE. Seven hundred thirty patients received a preemptive transplant with 7271 patients who were on dialysis before transplantation, with a mean age of 40.0 ± 11.6 years and 36.9 ± 11.7 years (P < .01), respectively. Women constituted 82.5% of preemptive and 81.4% of the non-preemptive groups (P = .47). Preemptive transplant recipients were more likely to receive a
Discussion
Preemptive kidney transplantation has been associated with superior graft and patient outcomes.1, 2, 3 The primary objective of this study was to compare posttransplant outcomes among patients with kidney failure due to SLE because it has been proposed that pretransplant dialysis in patients with lupus nephritis may permit the disease to become quiescent, hence reducing the risk of disease recurrence in the transplant kidney and improve graft survival.4, 5 However, the current study alleviates
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