Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients

Background: There are conflicting results regarding survival in preemptive versus non-preemptive kidney transplant recipients. The present study aimed to estimate the risk of death in preemptive versus non-preemptive kidney transplant recipients. Materials and Methods: In the present retrospective c...

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Main Authors: Firouzeh Moeinzadeh, Shahrzad Shahidi, Raheleh Heidari, Mojgan Mortazavi, Marjan Mansourian, Bahareh Botlani Yadegar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-02-01
Series:Journal of Research in Medical Sciences
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Online Access:https://journals.lww.com/10.4103/jrms.jrms_122_24
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author Firouzeh Moeinzadeh
Shahrzad Shahidi
Raheleh Heidari
Mojgan Mortazavi
Marjan Mansourian
Bahareh Botlani Yadegar
author_facet Firouzeh Moeinzadeh
Shahrzad Shahidi
Raheleh Heidari
Mojgan Mortazavi
Marjan Mansourian
Bahareh Botlani Yadegar
author_sort Firouzeh Moeinzadeh
collection DOAJ
description Background: There are conflicting results regarding survival in preemptive versus non-preemptive kidney transplant recipients. The present study aimed to estimate the risk of death in preemptive versus non-preemptive kidney transplant recipients. Materials and Methods: In the present retrospective cohort study, all end-stage renal disease (ESRD) patients who underwent kidney transplantation between 1996 and 2021 in referral kidney transplantation centers in Isfahan province were investigated. In total, 499 patients who received dialysis before kidney transplantation (non-preemptive) and 168 patients who received no dialysis before kidney transplantation (preemptive) were included in the final analysis. Data regarding demographic and clinical variables including sex, age, body mass index (BMI), follow-up duration, immunosuppressive regimen change, kidney donor type, underlying causes of ESRD, and comorbidities before and after kidney transplantation were collected. Results: The mean age was 55.47 ± 15.53 years in preemptive and 54.87 ± 14.69 years in non-preemptive patients (P = 0.65). Mortality rates were 24.44/1000 person-years of follow-up for preemptive and 18.25/1000 person-years of follow-up for non-preemptive patients (P = 0.013). In the crude model of Cox regression analysis, preemptive kidney transplant recipients had a significantly higher risk of mortality compared to non-preemptive kidney transplant recipients (hazard ratio [HR] = 1.59; 95% confidence interval [CI]: 1.09–2.33; P = 0.015). However, the association attenuated and became insignificant after adjustment for confounders, including age, BMI, immunosuppressive regimen change, kidney donor type, and comorbidities (HR = 1.35; 95% CI: 0.92–1.99; P = 0.12). Conclusion: The results of the present study indicated that there is no independent association between preemptive kidney transplantation and increased risk of mortality.
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spelling doaj-art-4943acf01c524ef096e4e0f0f4f4355c2025-08-20T02:53:19ZengWolters Kluwer Medknow PublicationsJournal of Research in Medical Sciences1735-19951735-71362025-02-01301111110.4103/jrms.jrms_122_24Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipientsFirouzeh MoeinzadehShahrzad ShahidiRaheleh HeidariMojgan MortazaviMarjan MansourianBahareh Botlani YadegarBackground: There are conflicting results regarding survival in preemptive versus non-preemptive kidney transplant recipients. The present study aimed to estimate the risk of death in preemptive versus non-preemptive kidney transplant recipients. Materials and Methods: In the present retrospective cohort study, all end-stage renal disease (ESRD) patients who underwent kidney transplantation between 1996 and 2021 in referral kidney transplantation centers in Isfahan province were investigated. In total, 499 patients who received dialysis before kidney transplantation (non-preemptive) and 168 patients who received no dialysis before kidney transplantation (preemptive) were included in the final analysis. Data regarding demographic and clinical variables including sex, age, body mass index (BMI), follow-up duration, immunosuppressive regimen change, kidney donor type, underlying causes of ESRD, and comorbidities before and after kidney transplantation were collected. Results: The mean age was 55.47 ± 15.53 years in preemptive and 54.87 ± 14.69 years in non-preemptive patients (P = 0.65). Mortality rates were 24.44/1000 person-years of follow-up for preemptive and 18.25/1000 person-years of follow-up for non-preemptive patients (P = 0.013). In the crude model of Cox regression analysis, preemptive kidney transplant recipients had a significantly higher risk of mortality compared to non-preemptive kidney transplant recipients (hazard ratio [HR] = 1.59; 95% confidence interval [CI]: 1.09–2.33; P = 0.015). However, the association attenuated and became insignificant after adjustment for confounders, including age, BMI, immunosuppressive regimen change, kidney donor type, and comorbidities (HR = 1.35; 95% CI: 0.92–1.99; P = 0.12). Conclusion: The results of the present study indicated that there is no independent association between preemptive kidney transplantation and increased risk of mortality.https://journals.lww.com/10.4103/jrms.jrms_122_24end-stage renal diseasepreemptive kidney transplantationsurvival
spellingShingle Firouzeh Moeinzadeh
Shahrzad Shahidi
Raheleh Heidari
Mojgan Mortazavi
Marjan Mansourian
Bahareh Botlani Yadegar
Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients
Journal of Research in Medical Sciences
end-stage renal disease
preemptive kidney transplantation
survival
title Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients
title_full Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients
title_fullStr Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients
title_full_unstemmed Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients
title_short Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients
title_sort comparison of survival outcomes in preemptive versus non preemptive kidney transplant recipients
topic end-stage renal disease
preemptive kidney transplantation
survival
url https://journals.lww.com/10.4103/jrms.jrms_122_24
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AT rahelehheidari comparisonofsurvivaloutcomesinpreemptiveversusnonpreemptivekidneytransplantrecipients
AT mojganmortazavi comparisonofsurvivaloutcomesinpreemptiveversusnonpreemptivekidneytransplantrecipients
AT marjanmansourian comparisonofsurvivaloutcomesinpreemptiveversusnonpreemptivekidneytransplantrecipients
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