The Effects of the Duration of Chronic Renal Failure and Hemodialysis on Transplanted Kidney

Yang, Pan Ho; So, Byung Jun; Chae, Kwon Mook

Abstract

Immunodeficiency of the patients with end-stage renal disease and various side effects of hemodialysis have been studied. We want to evaluate the effects of the duration of chronic renal failure(CRF) and hemodialysis on transplanted kidneys. This report is based on 111 patients who had received kidney transplantation at Wonkwang university hospital from August 1987 to march 1996. The patients were classified into 3 groups according to the duration of CRF; Group I(1yr and 5yr, n=15). The incidence of acute rejection within 6months was 28(60.8%) in group I, 31(62%) in group II, 9(60%) in group III. The 3-year graft survival rate was 34(73.9%), 38(76%), and 14(93.3%), respectively. The bacterial infection rate of each group within 1 year was 10(22%), 8(15%), and 4(28%). The viral infection rate of each group within 1 year was 15(33%), 11(27%), and 5(35%). To evaluate the effects of hemodialysis, the patients were divided into 3 groups; Group A(without hemodialysis, n=8(7.2%)), Group B(6 months, n=63(56.7%)). The incidence of acute rejection within 6months was 6(75%) in Group A, 24(60%) in Group B, 38(60.3%) in group C. The 3-year graft survival rate was 6(75%), 30(75%), and 50(79.3%), respectively. The bacterial infection rate of each group with 1 year was 2(25%), 10(25%) and 13(26%). The viral infection rate within 1 year was 2(25%), 16(40%) and 13(20.6%). The authors' analysis reveal the 3-year survival rate in the group III was higher than the other groups. But there was no significant difference of acute rejection rate, infection rate and wound complication rate. We suggest more basic study of the immune status of chronic renal failure patients is needed to provide proper immunosuppressive regimen according to the duration of end stage renal disease and hemodialysis.