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2015 ; 94
(34
): e1437
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The Risk of Septicemia in End-Stage Renal Disease With and Without Renal
Transplantation: A Propensity-Matched Cohort Study
#MMPMID26313801
Shen TC
; Wang IK
; Wei CC
; Lin CL
; Tsai CT
; Hsia TC
; Sung FC
; Kao CH
Medicine (Baltimore)
2015[Aug]; 94
(34
): e1437
PMID26313801
show ga
End-stage renal disease (ESRD) is a well-known risk factor for septicemia. Renal
transplantation (RTx) is the treatment of choice for ESRD. However, RTx
recipients should undergo long-term immunosuppressive therapy. The aim of this
study was to evaluate the risk of septicemia in ESRD patients with and without
RTx.This cohort study used the National Health Insurance (NHI) data of Taiwan
from 2000 to 2010. The RTx group consisted of 3286 RTx recipients. The non-RTx
comparison group also consisted of 3286 subjects with ESRD matched by propensity
scores for age, sex, index date, comorbidities, and medications. The subjects
were followed until the end of 2011 to evaluate the septicemia risk.The risk of
septicemia was lower in the RTx group than the non-RTx group, with an adjusted
hazard ratio of 0.73 [95% confidence interval (CI)?=?0.64-0.84, P?0.001]. In
addition, we observed insignificantly lower intensive care unit (ICU) admission
rate (35.8% vs. 39.8%) and lower 30-day all-cause mortality rate (17.2% vs.
18.5%) in the RTx group than the non-RTx group. However, the mean cost for
septicemia in the RTx group was insignificantly higher than the non-RTx group
(7175 vs. 6421 USD, P?=?0.39).RTx recipients had a significantly reduced risk of
developing septicemia compared to the propensity-matched non-RTx ESRD patients.
The ICU admission and 30-day all-cause mortality rates also slightly decreased in
RTx recipients but without statistical significance.