Academic Journal
Inequalities in outcomes after kidney transplant failure in the UK.
| Τίτλος: | Inequalities in outcomes after kidney transplant failure in the UK. |
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| Συγγραφείς: | Westaway S; Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.; North Bristol NHS Trust, Bristol, United Kingdom., Bailey PK; Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.; North Bristol NHS Trust, Bristol, United Kingdom., Santhakumaran S; UK Renal Registry, UK Kidney Association, Bristol, United Kingdom., Beresford M; Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.; Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom., Greenhall G; Barts Health NHS Trust, London, United Kingdom., Griffin S; University Hospital of Wales, Cardiff, United Kingdom.; Wales Kidney Research Unit, Wales, United Kingdom., Hole BD; Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.; North Bristol NHS Trust, Bristol, United Kingdom., Hilton R; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom., Masoud S; National Registry of Rare Kidney Diseases, Bristol, United Kingdom.; Centre for Kidney and Bladder Health, University College London, London, United Kingdom., Nitsch D; UK Renal Registry, UK Kidney Association, Bristol, United Kingdom.; The London School of Hygiene and Tropical Medicine, London, United Kingdom., Plumb L; Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.; Bristol Royal Hospital for Children, Bristol, United Kingdom., Robb M; NHS Blood and Transplant, Bristol, United Kingdom., Pippias M; Population Health Sciences, Bristol Medical School, Bristol, United Kingdom.; North Bristol NHS Trust, Bristol, United Kingdom. |
| Πηγή: | PloS one [PLoS One] 2026 Aug 26; Vol. 21 (8), pp. e0356769. Date of Electronic Publication: 2026 Aug 26 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: San Francisco, CA : Public Library of Science |
| Ιατρικοί όροι (MeSH): | Kidney Transplantation*/adverse effects , Kidney Failure, Chronic*/therapy, United Kingdom/epidemiology ; Humans ; Male ; Retrospective Studies ; Female ; Middle Aged ; Registries ; Treatment Failure ; Adult ; Renal Dialysis ; Glomerular Filtration Rate ; Aged ; Treatment Outcome |
| Περίληψη: | Background: Failing transplant management is an international research priority. The Failing Kidney Transplant Outcomes Registry Analysis (FAKTOR) is investigating management and outcomes of kidney transplant failure in the UK. Methods: A retrospective cohort analysis using UK Renal Registry data on adults (≥18 years) with kidney transplant failure (eGFR < 15ml/min/1.73m2) between 01/2012-12/2021. Treatment status was determined each year post-failure as the first status recorded of: i) re-transplantation, ii) haemodialysis (HD), iii) peritoneal dialysis (PD), iv) death; those alive without changing Kidney Replacement Therapy (KRT) modality classed as v) alive without new KRT, subclassified as vi) managed conservatively if eGFR < 7.5ml/min/1.73 m2 with no future dialysis. Treatment status was determined by one-year post-failure and reported by: age, sex, ethnicity, socioeconomic group, primary renal disease (PRD) and centre type (transplanting/non-transplanting). When applicable, last eGFR pre-dialysis was recorded. Regression models investigated the relationship between patient characteristics and centre type with outcomes: i) treatment status by one-year and ii) pre-dialysis eGFR. Results: We included 5447 patients. By one-year, 47.8% first received HD and 5.2% were pre-emptively re-transplanted. Black and Asian people were less likely to be re-transplanted than White people (Black Relative Risk Ratio (RRR) 0.41, 95% CI 0.20-0.87. Asian RRR 0.57, 0.34-0.96). Males were more likely to be re-transplanted (RRR 1.39, 1.06-1.81) and to receive HD (RRR 1.68, 1.47-1.92). Each quintile increase in deprivation was associated with a 22% lower re-transplantation likelihood (RRR 0.78, 0.71-0.86). Diabetic PRD was associated with higher mortality (RRR 1.97, 1.34-2.88) relative to glomerulonephritis. Median pre-dialysis eGFR was 9.6 ml/min/1.73 m2 (IQR 7.7-11.7) and 7.1% higher in non-transplanting compared with transplanting centres (+7.1%, + 2.6% to +11.9%). Conclusions: This first nationwide description of outcomes following kidney transplant failure in the UK highlights strong evidence of pre-emptive re-transplantation inequalities, favouring White people, those in less deprived areas and males. (Copyright: © 2026 Westaway et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
| Competing Interests: | The authors have declared that no competing interests exist. |
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| Entry Date(s): | Date Created: 20260826 Date Completed: 20260826 Latest Revision: 20260828 |
| Update Code: | 20260828 |
| PubMed Central ID: | PMC13514003 |
| DOI: | 10.1371/journal.pone.0356769 |
| PMID: | 42647538 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1932-6203 |
|---|---|
| DOI: | 10.1371/journal.pone.0356769 |