Background and purpose: We hypothesized a linear relative-risk model for graft survival of cadaveric renal transplantation, with a 6-month estimated glomerular filtration rate (GFR) employed as the linear parameter quantifying functioning renal mass and the detrimental effects of early chronic allograft nephropathy.
Methods: A retrospective study was conducted in a 15-year series of cadaveric renal transplantations (n = 227) with cyclosporin-based immunosuppression in a single transplant center. The Cockcroft-Gault formula was used for estimation of GFR, with a correction factor of 0.85 used for women. Stepwise Cox's regression analyses were applied to examine the prognostic significance of the 6-month estimated GFR.
Results: The Kaplan-Meier 5- and 10-year graft survival rates for this study were 80.67% and 59.43%, respectively. From univariate analysis, recipient gender, acute rejection and 6-month estimated GFR were significantly associated with graft survival (p < 0.05). Acute rejection became less significant (p = 0.0033) than 6-month estimated GFR (p = 0.0001) when 6-month estimated GFR was introduced in the stepwise regression procedures.
Conclusion: We demonstrated that 6-month estimated GFR is a significant prognostic indicator in cadaveric renal transplantation and is an essential parameter in the regression modeling of long-term graft survival.