Pediatric Nephrology

, Volume 25, Issue 12, pp 2517–2522

Mortality risk in children after renal allograft failure: a NAPRTCS study


    • Pediatric Nephrology, C.S. Mott Children’s HospitalUniversity of Michigan
  • Karen Martz
    • The EMMES Corporation
  • David Kershaw
    • Pediatric Nephrology, C.S. Mott Children’s HospitalUniversity of Michigan
  • John Magee
    • Transplant SurgeryUniversity of Michigan
  • Panduranga S. Rao
    • NephrologyUniversity of Michigan
Original Article

DOI: 10.1007/s00467-010-1631-x

Cite this article as:
Chen, A., Martz, K., Kershaw, D. et al. Pediatr Nephrol (2010) 25: 2517. doi:10.1007/s00467-010-1631-x


Studies have shown that adult dialysis patients with a failed renal allograft face a greater risk of mortality on dialysis compared with transplant-naïve patients. The outcome of children returning to dialysis after allograft failure has not been previously studied. Using the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) registry, we studied patients aged 2-21 years who initiated dialysis from 1 January 1992 to 31 December 2007. Of a total of 5,006 patients, 1,031 patients had a prior history of allograft failure and 3,975 did not (transplant-naïve). Demographic characteristics, including age at dialysis initiation, race, dialysis modality, primary renal disease, era of dialysis initiation, height Z score, and weight Z score were significantly different between the groups (p < 0.0001). Survival probability between the transplant-naïve and allograft failure groups was not significantly different (94.3% and 93.7% at 3 years respectively, log-rank p = 0.08). After covariate adjustment, allograft failure was not a significant factor contributing to increased mortality risk on dialysis (HR 0.98, CI 0.64–1.50, p = 0.94) based on Cox regression analysis. Children with failed allografts who return to dialysis are not at greater risk of mortality than their transplant-naïve dialysis counterparts.


DialysisRenal transplantSurvivalTransplant-naiveHemodialysisPeritoneal dialysis

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© IPNA 2010