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Causas de muerte en pacientes con un injerto renal funcionante: ¿Han ocurrido cambios en las últimas décadas? / Causes of death with a functioning graft among kidney allograft recipients
Vega, Jorge; Videla, Christian; Borja, Hernán; Goecke, Helmuth; Martínez, Felipe; Betancour, Pablo.
  • Vega, Jorge; Hospital Naval A. Nef. Servicio de Medicina Interna. Sección de Nefrología. Viña del Mar. CL
  • Videla, Christian; Hospital Dr. Gustavo Fricke. Servicio de Medicina Interna. Sección Nefrología. Viña del Mar. CL
  • Borja, Hernán; Hospital Dr. Gustavo Fricke. Servicio de Medicina Interna. Sección Nefrología. Viña del Mar. CL
  • Goecke, Helmuth; Hospital Naval A. Nef. Servicio de Medicina Interna. Sección de Nefrología. Viña del Mar. CL
  • Martínez, Felipe; Hospital Naval A. Nef. Servicio de Medicina Interna. Sección de Nefrología. Viña del Mar. CL
  • Betancour, Pablo; Hospital Naval A. Nef. Servicio de Medicina Interna. Sección de Nefrología. Viña del Mar. CL
Rev. méd. Chile ; 140(3): 295-304, mar. 2012. ilus, tab
Article in Spanish | LILACS | ID: lil-627641
ABSTRACT

Background:

Death with a functioning graft (DWGF) is now one of the main causes of renal transplant (RTx) loss.

Aim:

To determine whether the causes of DWGF, characteristics of donors and recipients and complications of RTx have changed in the last two decades. Subjects and

Methods:

Cooperative study of a cohort of 418 kidney grafts performed between 1968 and 2010. Patients were divided into two groups according to whether their kidney transplants were performed between 1968 and 1992 (Group 1) or 1993 and 2010 (Group 2).

Results:

Sixty eight patients experienced DWGF. Infections were the leading cause of DWGF in both groups (38 and 41%, respectively), followed by cardiovascular diseases (24 and 23% respectively), gastrointestinal disorders (21 and 26% respectively) and cancer (17 and 10% respectively). There were no significant differences in causes of death between the two groups according to the time elapsed since the renal transplantation. In patients in Group 1, the interval between diagnosis of renal failure and dialysis (HD) and the interval between the start of HD and kidney transplantation were significantly lower than in Group 2. The former had also an increased number of acute rejections in the first five years of kidney transplantation (p < 0.001). In Group 2, patients more often received their kidneys from deceased donors, had previous kidney transplantation, higher rate of antibodies to a panel of lymphocytes and an increased incidence of cardiovascular disorders after five years of RTx.

Conclusions:

The proportion of graft loss due to DWGF has increased over the last 2 decades, but its causes have not changed significantly. Infections are the most common causes of DWGF followed by cardiovascular and digestive diseases.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Kidney Transplantation / Graft Survival / Kidney Type of study: Etiology study / Prognostic study Limits: Adult / Female / Humans Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2012 Type: Article Affiliation country: Chile Institution/Affiliation country: Hospital Dr. Gustavo Fricke/CL / Hospital Naval A. Nef/CL

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Full text: Available Index: LILACS (Americas) Main subject: Kidney Transplantation / Graft Survival / Kidney Type of study: Etiology study / Prognostic study Limits: Adult / Female / Humans Language: Spanish Journal: Rev. méd. Chile Journal subject: Medicine Year: 2012 Type: Article Affiliation country: Chile Institution/Affiliation country: Hospital Dr. Gustavo Fricke/CL / Hospital Naval A. Nef/CL