Dialysis patients who smoke less likely to get transplant

Dialysis patients who smoke are less likely to get a kidney transplant and are more likely to die earlier than non-smoking kidney disease sufferers, according to a new study led by Limerick researchers.

The findings, published in the online medical journal BMC Nephrology, provide compelling evidence that smoking reduces overall life expectancy of dialysis patients. It also finds their overall poor chances of receiving a kidney transplant.

“Smoking remains a major modifiable risk factor for adverse outcomes for men and women on dialysis. It shortens their lifespans and reduces their overall chances of kidney transplantation,” said Prof Austin Stack MD, lead author and consultant nephrologist at University Limerick Hospitals and director of UL Health Research Institute.

About 2m patients in the world are treated with dialysis every year, and kidney transplantation is by far the best option for most patients who develop kidney failure.

According to researchers from the Health Research Institute and UL’s graduate entry medical school, patients with kidney failure who are on dialysis have life spans that can be a fifth that of the general population.

Using data from the US renal registry, the research team followed 1,220,000 patients for two years, who began dialysis in the US from 1995 to 2010.

Among the major findings were that smoking had a far greater negative impact on the lifespans of younger men and women than among older patients.

“Dialysis patients have extremely high premature death rates that are between 10 and 100-fold higher than in the general population, and smoking contributes substantially to lower patient survival,” said Prof Stack.

“Our study, one of the largest ever conducted, found that smokers have alarmingly high rates of premature death. Quite strikingly, the risks of death were far greater in younger men and younger women than in older patients.”

He said “equally concerning” was that dialysis patients who smoke experienced lower rates of kidney transplantation and thus the change to extend survival.

“These risks were considerable in that smokers were between 26% and 50% less likely to receive a kidney transplant taking all other factors into consideration.

“Smoking is a major risk amplifier for all patients on dialysis” he added.

“Consequently, we believe that kidney specialists and all healthcare providers should engage with their patients to pursue smoking cessation strategies at each and every opportunity.”


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