Study: The Sooner, The Better for Dialysis Patients Awaiting Kidney Transplants

The longer patients with failing kidneys wait on dialysis for a transplant, the worse they fare, according to University of Florida researchers.

Report in the journal Transplantation, the researchers said their analysis of data from the U.S. Renal Data System and the U.S. Scientific Renal Transplant Registry for transplants performed between 1988 and 1998 showed that patients who on dialysis for two years have a three times greater chance of losing their transplanted kidney than those who wait less than six months.

"Dialysis keeps you alive, but you do not get the same benefit as with transplantation," said Dr. Bruce Kaplan. "Yet as recently as a year or two ago, people weren't really aware of how bad it was to wait for a kidney. But the time you spend waiting has a huge impact. It becomes critically important, therefore, to get a transplant as soon as possible."

The researchers also reported finding that while patients who receive a kidney from a living related donor typically do better than those who get one from a cadaver, those benefits fade if patients wait for the living donor organ for two years or longer.

"Everyone in the transplant community is used to saying that living related donors are just better than cadaveric donors," Kaplan said. "But much of the benefit of a live donor kidney is actually the shortened waiting time.

"Our study showed that if you got a cadaveric donor kidney in less than six months or you waited two years to get a live donor kidney, the results were pretty much the same," Kaplan said.

Despite these findings, Kaplan said patients should understand that even if they must wait years, transplantation still confers tremendous benefit over dialysis.

"It's better to get the transplant earlier, but even if you get it late, you're still getting an enormous benefit," he said. "Kidney transplantation is pretty much a lifesaving therapy."

In their study, the University of Florida researchers tracked outcomes for 2,500 pairs of cadaveric kidneys taken from the same donor. In each case, one kidney went to a patient on dialysis for less than six months, while the other went to a patient on dialysis for more than two years.

After a decade, the transplanted kidneys were still functioning in 69 percent of the patients on short-term dialysis but only functioning in 39 percent of the patients who had undergone more than two years of dialysis.

Other sources: Transplantation