Management of end-stage XXXX with hemodialysis and transplantation.

@entity1 @entity8 @entity1621 @entity454
This is an analysis of the outcome of 35 @entity1 with end-stage @entity8 ( @entity8 ) at Toronto Western Hospital (TWH) during a 10-year period. The primary treatment in each case was hemodialysis. In the 15 @entity1 managed exclusively with hemodialysis the one- and five-year actuarial survival was 93% and 77% respectively. Twenty @entity1 ultimately received a total of 26 cadaveric renal allografts. Graft survival at one year was 76%. One- and five-year @entity1 survival was 92% and 73% respectively. Beyond 5 years a trend towards increased survival in the transplant group was seen, compared with the exclusively hemodialyzed group. @entity1621 prior to transplantation was associated with high morbidity and mortality, and did not change either graft or @entity1 survival. In view of the similar survival and because it is accepted that transplantation offers the highest quality of life amongst the modalities of treatment for @entity454 , transplantation should be considered the treatment of choice for end-stage @entity8 . There is no justification for routine bilateral nephrectomy before renal transplantation.
