Relationship between underlying renal disease and renal transplantation outcome

The purpose of this study is to better characterize graft and patient survi val posttransplantation by examining survival according to underlying renal disease for all first-time renal allograft recipients in the United Networ k for Organ Sharing (UNOS) registry. From 1987 through 1996, the UNOS regis try collected data on 23,838 living and 67,183 cadaveric renal transplantat ions. This investigation included all patients undergoing their first renal transplantation for whom the underlying cause of renal failure could be id entified and categorized. Gross 1- and 3-year patient and graft survival ac cording to underlying renal disease are included. In addition, a Cox propor tional hazards model was created to analyze the effect of underlying diseas e on graft and patient survival after adjusting for comorbid conditions, de mographics, and type of renal transplant (living versus cadaveric). The ass ociation between underlying disease and graft and patient survival is shown . Amyloidosis, sickle cell anemia, scleroderma, and radiation nephritis are associated with poor graft and patient survival. The risk ratio for patien t mortality was more than twice that for immunoglobulin A nephropathy for a number of conditions, including analgesic nephropathy, amyloidosis, and bo th forms of diabetes mellitus, (C) 2001 by the National Kidney Foundation, Inc.