Factors associated with survival of kidney allografts.

The effect of an exercise program during hemodialysis on dialysis efficacy, blood pressure and quality of life in end-stage renal disease (ESRD) patients. Kidney transplantation is generally accepted as the best way for renal replacement therapy in patients with end-stage renal disease. Kidney transplant recipients could have a relatively high quality of life compared with maintenance hemodialysis. 6,7 Despite the successful kidney transplant surgeries, rejection rate has still a high percentage in these patients; about 10% of them experience rejection within the first year. 8 Knowing the high rate of complications and risk factors affecting kidney allograft survival, most of which are predictable and preventable, this issuehasbecomeincreasinglyimportant. Long-term kidney allograft survival has not paralleled improvements made in the past three decades in short-term survival. As mentioned in the literature, factors that may be related to short-and long-term survival are diverse and various. 9 A main question to be answered about outcomes in kidney transplantationis which factors are associated with short-and long-term graft survival. Accumulating evidence supports that some of the accepted risk factors can be prolonged pretransplant dialysis time, pretranplant and posttransplant hypertension,the use of expanded criteria donors, higher serum levels of creatinine at the time of the first discharge, racialand ethnicdifferencesthatare relatedto thelevelof health services, underlying disease (diabetes mellitus), body mass index, age of recipients, donor type, proteinuria, sex ofrecipient and donor, and infections. 2-6,10-15 In the current issue of the IranianJournal of Kidney Diseases, Mirzaee and colleagues present an effective cure model analysis for improve short-and long-term survival rates of kidney allograft. They used a mixture of cure models to assess the short-and the long-term survival rate. 16 They concluded that pretransplant hypertension, body mass index, a serum creatinine level of 1.6 mg/dL and greater upon discharge from the hospital, and donor age and sex were the risk factors affecting the survival of the kidney allograft. These time-dependent survival factors could be improved by controlling effective variables.Since the long-term kidney allograft survival remains an elusive goal,many studiesare being conductedinthis field, in order tohelpthese patientstohavea better life. The association of many factors such as female sex, black race, older donor age, deceased donor source, delayed graft function, and acute rejection with the duration of allograft survivalformed the basis of study conducted by Gilland colleagues on the relationship between glomerular filtration rate changes and long-term kidney allograft survival. 20 They explained that strategies for improvinglong-term kidney allograft survival that increase …