Mulay, Atul Vasant2013-11-072013-11-0720072007Source: Masters Abstracts International, Volume: 47-06, page: 3499.http://hdl.handle.net/10393/27895http://dx.doi.org/10.20381/ruor-12300Background. Recurrent glomerulonephritis is third most common cause of kidney transplant failure. Methods. We used the United States Renal Data System to determine the association of routine post-transplantation immunosuppressant use with time to renal allograft failure due to recurrent glomerulonephritis. Immunosuppressants were treated as time-varying covariates. The study-cohort included patients with kidney failure due to glomerulonephritis who received first kidney transplant between 1990 and 2003. Important confounders were identified through a systematic review of literature and missing values in the dataset were handled by multiple imputation. Results. The study cohort included 41,272 patients with a median follow-up of 51 (22--90) months. Ten-year overall graft survival (including death as graft loss) and death-censored graft survival was 56.2% (55.5%--56.9%) and 70.5% (69.8%--71.1%) respectively. Ten-year incidence of graft loss due to recurrent glomerulonephritis was 2.6% (2.3--2.8%). Use of cyclosporine, tacrolimus, azathioprine or mycophenolate mofetil was not associated with risk of graft failure due to recurrent glomerulonephritis alter adjusting for important covariates. There was no difference of recurrent glomerulonephritis causing graft failure between cyclosporine and tacrolimus or between azathioprine and mycophenolate mofetil. Change in any immunosuppressant during follow-up was independently associated with graft loss due to recurrence (HR 1.31, 95%CI 1.07--1.60, p=0.01). Conclusion. Routinely used post-transplantation immunosuppressants have no impact on the risk of graft loss due to recurrent glomerulonephritis.144 p.enHealth Sciences, Medicine and Surgery.Health Sciences, Epidemiology.Thesis