The Analysis On Survival Rate, Life Quality, And Related Factors Of Patients Who Return To Dialysis After Renal Transplant Failure

BackgroundAccording to statistics, about 4% kidney transplant patients face the risk of kidney allograft loss per year. Once kidney allograft loss occurs, hemodialysis will be the important replacement therapy for patients to sustain life.The present studies at home and abroad seldom indicate if there is any difference between hemodialysis patients without renal transplantation and patients with kidney allograft loss back to hemodialysis, as the factors of transplant allograft rejection, using of immunosuppressant, and high medical costs in the earlier stage they experienced.ObjectiveTo compare the differences in survival and its influence factors of kidney allograft loss patients, who return to dialysis, with haemodialysis patients without renal transplantation. And this can help us to develop appropriate individualised treatment plans with patients.To compare the differences in state of mind, quality of life(QOL) of above two groups of patients. The aim of this study was to improve the quality of life of kidney allograft loss patients, with humanistic care.Methods118 patients on maintenance hemodialysis were recruited in the Seventh Hospital of Zhengzhou from 2004 to 2015. We performed that 28 patients who return to dialysis after renal transplant failure as renal transplant failure group, and the other 90 haemodialysis patients without renal transplantation as control group. KDQOL-SFTM1.3 was used to assess the QOL of the patients by "one to one", while collect the characteristics of patients. The t-test, chi-square test, one-way ANOVA, Kaplan-Meier Survival analysis, Cox’s proportional hazards regression model, multiple stepwise regression analysis of data are processed by SPSS 17.0.Results1. Campared with control group, the renal transplant failure group have lower survival rate.2. The main causes of death were infection events on renal transplant failure group, while were cardiovascular events on control group.3. For renal transplant failure group, multivariate COX regression analysis showed systolic pressure, parathyroid hormone, diabetes, cerebral vascular disease are the risk factors for survival.However, for control group, dialysis frequency, hemoglobin, albumin, KT/V are the risk factors for survival.4. Comparing the life quality in both groups, patients in the control group have advantages in disease symptoms, discomfort and social support aspects. While, patients in the renal transplant failure group have advantages in working condition and patients’ satisfaction. In the both groups, the SF-36/KDTA score of elder patients who are low educated, have multiple complications and frequent hospilizated are lower.5. In renal transplant failure group, parathyroid hormone and serum creatinine level are significant independent predictors of patients’ life quality. While, in control group, urea nitrogen, serumalbumin and Kt/v are significant independent predictors of patients’ life quality.ConclusionsThis study takes hemodialysis patients with renal transplant failure and without renal transplantation as subjects, observes the differences between two groups in survival rate, life quality and other related factors. The result shows that the survival rate in patients without renal transplantation is higher than patients in renal transplant failure group. The main cause of death in control group is cardiovascular events, while the main cause of death in experimental group is infection.Analyzing the factors related to survival rate and life quality in both groups, shows that, hemodialysis frequency, serum albumin level, hemoglobin levels, urea nitrogen, Kt/v are the main factors to affect survival rate and life quality of patients without renal transplantation; While, systolic pressure, diabetes, hematocrit value, parathyroid hormone level and serum creatinine level are the main factors to affect survival rate and life quality of patients with renal transplant failure.