ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO720

Survival Advantage of Renal Transplantation over Dialysis Is Blunted in Women

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Sapoznikov, Dan, Hadassah Hebrew University Medical Center, Jerusalem, Israel
  • Dranitzki Elhalel, Michal, Hadassah Hebrew University Medical Center, Jerusalem, Israel
  • Rubinger, Dvora, Hadassah Hebrew University Medical Center, Jerusalem, Israel
Background

The effect of gender on long term outcome in end stage renal disease is not well defined. Decreased LFα, a baroreflex index, and increased sdSV (stroke volume variability, a measure of myocardial responsiveness) were shown to predict poor prognosis in hemodialysis (HD) patients.

Methods

To assess factors associated with long term survival, clinical data and death events were monitored in 126 men (M) and 70 women (F) on HD and after renal transplantation (TX) during a follow up of 60 months. Continuous interbeat interval (IBI) and systolic blood pressure (SBP) and their variabilities were recorded using Finometer. LFα and sdSV were calculated from SBP and IBI spontaneous variations.

Results

Kaplan-Meier analysis showed a similar (76%) 5 yr survival in HD M and F. A significantly increased survival was noted in TX M compared with HD M (91%, p=0.031) while no such difference was noted in TX F (Figure1). Main death risk factors, LF α and sdSV are shown in Table 1. Age range, the prevalence of diabetes mellitus, hyperlipidemia and HD vintage were similar in M and F.TX was associated with improved blood pressure in all patients. Renal function was similar in TX M and F.

Conclusion

Our data show that despite higher comorbidity prevalence, TX significantly improved survival in M. The enhanced survival in TX M was associated with increased LFα and decreased sdSV, suggesting improved autonomic function. In F no significant changes in these measures were found and the survival benefit of TX was less prominent. The causes of the reduced effect of TX in F remain to be determined.

Table 1.
nHD M (75)HD F (44)pTX M (51)TX F (26)p
Hypertension [n(%)]71 (95)36 (82)0.02546 (92)21 (81)0.151
Ischemic heart disease [n(%)]44 (59)22 (50)0.35819 (38)3 (12)0.016
Smoking [n(%)]38 (51)7 (16)0.00119 (38)0 (0)0.001
LF α (ms/mmHg)* #3.44 (2.80)3.44 (2.80)0.5733.87 (4.00)^4.15 (4.10)0.249
sdSV (ml)#6.65 (2.80)5.40 (2.30)0.0164.92 (2.50)^^4.78 (2.30)0.914

* Square root of average IBI and SBP powers in the low frequency (LF) range. # Median and interquartile ranges. p vs. HD M:^0.003;^^0.001:

Figure 1.