Table 5.
Adjusted associations of early post-transplant dialysis utilization with graft failure and patient death
| Patient Death | Graft Failure | |||
|---|---|---|---|---|
| Variable | Odds Ratio | 95% CI | Odds Ratio | 95% CI |
| DGF– dialysis 1st week only | 1.24 | (1.17 – 1.32)* | 1.24 | (1.18 – 1.3) * |
| DGF– dialysis in 2 periods† | 1.60 | (1.45 – 1.78) * | 1.66 | (1.53 – 1.8) * |
| DGF– dialysis in more than 2 periods† | 2.08 | (1.83 – 2.36) * | 2.23 | (2.02 – 2.47) * |
| No DGF – some dialysis | 1.61 | (1.44 – 1.8) * | 1.54 | (1.41 – 1.69) * |
| No DGF – no dialysis | Reference | Reference | ||
| Recipient characteristics | ||||
| Female | 0.92 | (0.87 – 0.97) * | 0.91 | (0.87 – 0.95) * |
| Race | ||||
| African American | 0.94 | (0.88 – 1.01) * | 1.27 | (1.21 – 1.33) * |
| White | Reference | Reference | ||
| Other | 0.70 | (0.61 – 0.8) * | 0.79 | (0.71 – 0.88) * |
| Age (years) | ||||
| 18–30 | Reference | Reference | ||
| 31–44 | 1.41 | (1.21 – 1.63) * | 0.86 | (0.8 – 0.94) * |
| 45–59 | 2.17 | (1.88 – 2.5) * | 0.86 | (0.79 – 0.93) * |
| ≥ 60 | 3.38 | (2.93 – 3.89) * | 1.06 | (0.98 – 1.16) |
| BMI category (kg/m2) | ||||
| < 10 or Missing | 1.01 | (0.95 – 1.08) | 1.04 | (0.99 – 1.1) |
| ≥10 to <25 | Reference | Reference | ||
| ≥ 25 to <30 | 0.91 | (0.85 – 0.98) * | 0.95 | (0.9 – 1.01) |
| ≥ 30 | 1.02 | (0.94 – 1.11) | 1.09 | (1.02 – 1.16) * |
| Primary cause of ESRD | ||||
| Diabetes mellitus | 1.55 | (1.41 – 1.7) * | 1.19 | (1.1 – 1.28) * |
| Hypertension | 1.05 | (0.95 – 1.16) | 1.07 | (0.99 – 1.15) |
| Glomerulonephritis | 0.81 | (0.73 – 0.9) * | 0.90 | (0.83 – 0.98) * |
| PKD | 0.66 | (0.58 – 0.76) * | 0.70 | (0.63 – 0.78) * |
| Other | Reference | Reference | ||
| Unknown | 1.00 | (0.89 – 1.12) | 1.02 | (0.93 – 1.11) |
| Hispanic | 1.49 | (1.36 – 1.63) * | 1.24 | (1.16 – 1.33) * |
| PVD | 1.32 | (1.19 – 1.46) * | 1.24 | (1.13 – 1.36) * |
| Pre-Transplant Dialysis | ||||
| None (pre-emptive) | 0.96 | (0.84 – 1.11) | 0.92 | (0.83 – 1.03) |
| 0–12 months | Reference | Reference | ||
| 13–24 months | 1.02 | (0.92 – 1.14) | 1.00 | (0.92 – 1.08) |
| 25–60 months | 1.00 | (0.92 – 1.1) | 0.94 | (0.87 – 1.01) |
| More than 60 months | 1.15 | (1.03 – 1.28) * | 1.00 | (0.92 – 1.09) |
| Donor Characteristics | ||||
| Female | 1.03 | (0.98 – 1.09) | 1.08 | (1.04 – 1.13) * |
| Race | ||||
| African American | 1.08 | (0.99 – 1.17) | 1.18 | (1.11 – 1.26) * |
| White | Reference | Reference | ||
| Other | 0.98 | (0.84 – 1.14) | 1.00 | (0.89 – 1.13) |
| Age (years) | ||||
| ≤ 18 | 1.03 | (0.94 – 1.12) | 1.03 | (0.96 – 1.1) |
| 19–30 | Reference | Reference | ||
| 31–44 | 1.05 | (0.97 – 1.13) | 1.10 | (1.03 – 1.17) * |
| 45–59 | 1.17 | (1.07 – 1.26) * | 1.25 | (1.17 – 1.34) * |
| ≥ 60 | 1.19 | (1.04 – 1.36) * | 1.44 | (1.29 – 1.6) * |
| BMI category (kg/m2) | ||||
| < 10 or Missing | 0.97 | (0.86 – 1.1) | 1.01 | (0.91 – 1.11) |
| ≥10 to <25 | Reference | Reference | ||
| ≥ 25 to <30 | 0.94 | (0.88 – 1) | 0.95 | (0.9 – 1) |
| ≥ 30 | 1.01 | (0.94 – 1.09) | 0.95 | (0.9 – 1.01) |
| Death due to stroke | 1.09 | (1.02 – 1.16) * | 1.11 | (1.05 – 1.17) * |
| Terminal Creatinine ≥ 1.5 | 0.94 | (0.87 – 1.01) | 1.01 | (0.96 – 1.08) |
| Hypertension history | 1.02 | (0.95 – 1.1) | 1.06 | (1 – 1.13) * |
| Diabetes | 1.14 | (1 – 1.29) * | 1.16 | (1.04 – 1.28) * |
| Transplant Factors | ||||
| Donor Type | ||||
| SCD | Reference | Reference | ||
| ECD | 1.19 | (1.06 – 1.33) * | 1.10 | (1.01 – 1.2) * |
| DCD | 1.07 | (0.88 – 1.3) | 1.02 | (0.87 – 1.19) |
| Peak PRA % | ||||
| 0–10% | Reference | Reference | ||
| 11–30% | 1.02 | (0.94 – 1.1) | 1.07 | (1 – 1.14) |
| >30% | 1.19 | (1.1 – 1.28) * | 1.22 | (1.15 – 1.3) * |
| Unknown | 1.19 | (1.01 – 1.42) * | 1.10 | (0.95 – 1.26) |
| HLA Mismatches | ||||
| 0 HLA mismatches | Reference | Reference | ||
| 1 HLA mismatches | 1.09 | (0.96 – 1.25) | 1.08 | (0.97 – 1.22) |
| 2 HLA mismatches | 1.10 | (0.97 – 1.23) | 1.18 | (1.07 – 1.3) * |
| 3 HLA mismatches | 1.16 | (1.04 – 1.29) * | 1.22 | (1.11 – 1.33) * |
| 4 HLA mismatches | 1.18 | (1.06 – 1.32) * | 1.30 | (1.19 – 1.42) * |
| 5 HLA mismatches | 1.21 | (1.08 – 1.35) * | 1.29 | (1.17 – 1.41*) |
| 6 HLA mismatches | 1.22 | (1.06 – 1.4) * | 1.34 | (1.2 – 1.5) * |
| Unknown | 1.20 | (1 – 1.45) * | 1.27 | (1.09 – 1.47) * |
| CMV sero-pairing | ||||
| Donor − / Recipient − | Reference | Reference | ||
| Donor − / Recipient + | 1.15 | (1.04 – 1.27) * | 1.12 | (1.03 – 1.21) * |
| Donor + / Recipient − | 1.27 | (1.15 – 1.42) * | 1.24 | (1.14 – 1.35) * |
| Donor + / Recipient + | 1.23 | (1.11 – 1.35) * | 1.16 | (1.08 – 1.25) * |
| Unknown | 1.21 | (1.07 – 1.36) * | 1.17 | (1.06 – 1.28) * |
| Cold-time | ||||
| 0 – 14 hours | Reference | Reference | ||
| 15 – 19 hours | 0.99 | (0.92 – 1.07) | 1.02 | (0.96 – 1.08) |
| 20 – 25 hours | 1.07 | (1 – 1.16) | 1.11 | (1.05 – 1.18) * |
| 26+ hours | 1.05 | (0.97 – 1.13) | 1.07 | (1.01 – 1.14) * |
| Unknown | 1.01 | (0.9 – 1.13) | 1.03 | (0.95 – 1.13) |
| Year | ||||
| 1995 | Reference | Reference | ||
| 1996 | 0.94 | (0.85 – 1.03) | 0.94 | (0.87 – 1.02) |
| 1997 | 0.99 | (0.9 – 1.09) | 0.95 | (0.88 – 1.02) |
| 1998 | 1.01 | (0.91 – 1.11) | 0.95 | (0.88 – 1.02) |
| 1999 | 0.99 | (0.89 – 1.1) | 0.92 | (0.85 – 1) |
| 2000 | 1.09 | (0.97 – 1.21) | 1.02 | (0.94 – 1.11) |
| 2001 | 1.04 | (0.92 – 1.17) | 0.92 | (0.84 – 1.01) |
| 2002 | 0.96 | (0.83 – 1.1) | 0.96 | (0.86 – 1.06) |
| 2003 | 0.96 | (0.82 – 1.14) | 0.90 | (0.79 – 1.03) |
| 2004 | 0.92 | (0.7 – 1.22) | 0.90 | (0.73 – 1.12) |
*
P-value < 0.05
†
Periods of early dialysis were first week, the second week, weeks 3 or 4, the second month and the third month post-transplant