Grant: Operating Grant

Patients with end-stage kidney disease can be treated with long-term dialysis or receive a kidney transplant. Research has shown that patients who receive a kidney transplant have an improvement in survival and quality of life. Unfortunately, not all kidney transplants last forever and many patients have to go back on dialysis treatments. Patients who have transplant failure and resume dialysis have a significantly increased risk of complications and death compared to those who maintain kidney transplant function. They also have worse outcomes compared to other dialysis patients who never received a transplant. The cause of this poor outcome is not known. We speculate that it is due to patients remaining on immunosuppressive medications for too long after the transplant has failed. In this study, we will evaluate patients who suffer kidney transplant failure at all of the adult kidney transplant programs in Canada. We will carefully measure the amount of medication taken, the occurrence of complications such as serious infections as well as their survival. Information from this study will be used to guide practice in this area. This study will show health care professionals the best methods to manage medication in order to improve outcomes for this patient population. Such improvements for the growing number of patients with end-stage kidney disease would represent an important advance in the management of this very disabling and lethal long-term condition.