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Kidney transplantation prolongs survival compared with home hemodialysis

American Society of Nephrology

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Credit: Molnar

Highlights

  • Among kidney failure patients who were followed for 5 years, home hemodialysis patients were 4-times more likely to die than kidney transplant recipients.
  • In elderly kidney failure patients, home hemodialysis patients had nearly a 5-times higher risk of dying during follow-up than kidney transplant patients.
  • The studies' findings will be presented at ASN Kidney Week 2015 November 3-8 at the San Diego Convention Center in San Diego, CA.

San Diego, CA (November 6, 2015) -- Previous studies have found that kidney failure patients on long-term dialysis tend to die earlier than patients who receive kidney transplants; however, none of these studies have considered death rates in US patients using alternative forms of dialysis such as home hemodialysis. Two such studies will be presented at ASN Kidney Week 2015 November 3¬-8 at the San Diego Convention Center in San Diego, CA.

Miklos Zsolt Molnar, MD, PhD, FEBTM, FERA, FASN (University of Tennessee Health Science Center) and his colleagues compared information on 2000 patients who started home hemodialysis with 2000 who received kidney transplants in the United States between 2007 and 2011.

Over 5 years of follow-up, home hemodialysis patients were 4-times more likely to die than kidney transplant recipients. "There was a significant interaction with race for the association of treatment modality with mortality," said Dr. Molnar. "In African Americans, mortality risk increased after the first year as the survival lines were separated only after this time-point, while in Whites the survival lines were separated from the beginning of the follow-up." He noted that additional studies are needed to understand the reasons underlying racial differences in the risk of premature death in home hemodialysis vs. kidney transplant patients.

In a second study, Dr. Molnar and his team compared mortality rates in 480 elderly (>65 years old) patients using home hemodialysis with 480 matched kidney transplant recipients. In this case, home hemodialysis patients had nearly a 5-times higher risk of dying during follow-up than kidney transplant patients. Results were consistent across different types of kidney donors and subgroups divided by various recipient characteristics.

"Further studies are needed to assess whether kidney transplant also provides better quality of life or lower hospitalization rates compared with home hemodialysis in elderly patients with end stage renal disease," said Dr. Molnar.

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Studies: 1) "Racial Differences in Survival of Incident Home Hemodialysis and Kidney Transplant Patients" (Abstract FR-PO1007). 2) "Survival of Elderly Incident Home Hemodialysis and Kidney Transplant Patients" (Abstract FR-PO1008)

Disclosures: Csaba P. Kovesdy is a consultant for Relypsa, ZS Pharma; receives research funding from Abbvie, Amgen, OPKO, Shire; receives honoraria from Sanofi-Aventis, Relypsa, ZS Pharma; and receives royalties from UpToDate. Kamyar Kalantar-Zadeh is a consultant for Abbott, Abbvie, Amgen, AstraZeneca, Fresenius, Hospira, Keryx, Otsuka, Sanofi, Shire, Vifor; receives research funding from Shire, Aveo, NIH; receives honoraria from Abbott, Abbvie, Amgen, ASN, Aveo, DaVita, Fresenius, Genetech, Hospira, Keryx, NIH, NKF, Relypsa, Resverlogix, Sanofi, Shire, Vifor, ZS-Pharma; owns a patent for prognostic assays for maintenance hemodialysis patients; and is a scientific advisor for Abbott, Abbvie, Amgen, Aveo, DaVita, Fresenius, Genetech, Hospira, Keryx,, NKF, Relypsa, Resverlogix, Sanofi, Shire, Vifor, ZS-Pharma; and is on the speakers bureau for Abbott, Abbvie, Amgen, Fresenius, Keryx, Relypsa, Sanofi, Shire, Vifor2.

ASN Kidney Week 2015, the largest nephrology meeting of its kind, will provide a forum for more than 13,000 professionals to discuss the latest findings in kidney health research and engage in educational sessions related to advances in the care of patients with kidney and related disorders. Kidney Week 2015 will take place November 3-8, 2015 in San Diego, CA.

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Founded in 1966, and with nearly 16,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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