Patient survival after renal transplantation: II. The impact of smoking

Fernando G Cosio, Michael E. Falkenhain, Todd E. Pesavento, Susan Yim, Amir Alamir, Mitchell L. Henry, Ronald M. Ferguson

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Renal transplant recipients have significantly higher mortality than individuals without kidney disease and the excess mortality is mainly due to cardiovascular causes. In this study, we sought to determine the impact of smoking, a major cardiovascular risk factor, on patient and renal graft survival. The study population included all adult recipients of first cadaveric kidney transplants done in our institution from 1984 to 1991. By selection, all patients were alive and had a functioning graft for at least 1 yr after transplantation. Smoking history was gathered prior to transplantation. The follow-up period was 84.3 ± 41 months and during this time 28% of the patients died and 21% lost their graft. By univariate and multivariate analysis, patient survival, censored at the time of graft loss, correlated with these pre-transplant variables: age (p < 0.0001); diabetes (p = 0.0002); history of cigarette smoking (p = 0.004); time on dialysis prior to the transplant (p = 0.0005); and cardiomegaly by chest X-ray (p = 0.0005). Posttransplant variables did not correlate with patient mortality. By Cox regression, patient survival time was significantly shorter in diabetics (p < 0.0001), smokers (p = 0.0005), and recipients older than 40 yr. However, there were no significant differences between the survival of smokers, non-diabetics, diabetics, and older recipients. Patient death was the most common cause of renal transplant failure in smokers, in patients older than 40 yr, and in diabetics, but these patient characteristics did not correlate with graft survival. The prevalence of different causes of death was not significantly different between smokers and non-smokers. In conclusion, a history of cigarette smoking correlates with decreased patient survival after transplantation, and the magnitude of the negative impact of smoking in renal transplant recipients is quantitatively similar to that of diabetes.

Original languageEnglish (US)
Pages (from-to)336-341
Number of pages6
JournalClinical Transplantation
Volume13
Issue number4
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Kidney Transplantation
Smoking
Survival
Transplants
Kidney
Transplantation
Graft Survival
Mortality
Kidney Diseases
Cardiomegaly
Renal Insufficiency
Dialysis
Cause of Death
Thorax
Multivariate Analysis
History
X-Rays

Keywords

  • Cardiovascular
  • Kidney
  • Mortality
  • Smoking
  • Survival
  • Transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Cosio, F. G., Falkenhain, M. E., Pesavento, T. E., Yim, S., Alamir, A., Henry, M. L., & Ferguson, R. M. (1999). Patient survival after renal transplantation: II. The impact of smoking. Clinical Transplantation, 13(4), 336-341. https://doi.org/10.1034/j.1399-0012.1999.130410.x

Patient survival after renal transplantation : II. The impact of smoking. / Cosio, Fernando G; Falkenhain, Michael E.; Pesavento, Todd E.; Yim, Susan; Alamir, Amir; Henry, Mitchell L.; Ferguson, Ronald M.

In: Clinical Transplantation, Vol. 13, No. 4, 1999, p. 336-341.

Research output: Contribution to journalArticle

Cosio, FG, Falkenhain, ME, Pesavento, TE, Yim, S, Alamir, A, Henry, ML & Ferguson, RM 1999, 'Patient survival after renal transplantation: II. The impact of smoking', Clinical Transplantation, vol. 13, no. 4, pp. 336-341. https://doi.org/10.1034/j.1399-0012.1999.130410.x
Cosio FG, Falkenhain ME, Pesavento TE, Yim S, Alamir A, Henry ML et al. Patient survival after renal transplantation: II. The impact of smoking. Clinical Transplantation. 1999;13(4):336-341. https://doi.org/10.1034/j.1399-0012.1999.130410.x
Cosio, Fernando G ; Falkenhain, Michael E. ; Pesavento, Todd E. ; Yim, Susan ; Alamir, Amir ; Henry, Mitchell L. ; Ferguson, Ronald M. / Patient survival after renal transplantation : II. The impact of smoking. In: Clinical Transplantation. 1999 ; Vol. 13, No. 4. pp. 336-341.
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