End-stage renal disease (
ESRD) is a well-known risk factor for
septicemia.
Renal transplantation (RTx) is the treatment of choice for
ESRD. However, RTx recipients should undergo long-term immunosuppressive therapy. The aim of this study was to evaluate the risk of
septicemia in
ESRD patients with and without RTx.This cohort study used the National Health Insurance (NHI) data of Taiwan from 2000 to 2010. The RTx group consisted of 3286 RTx recipients. The non-RTx comparison group also consisted of 3286 subjects with
ESRD matched by propensity scores for age, sex, index date, comorbidities, and medications. The subjects were followed until the end of 2011 to evaluate the
septicemia risk.The risk of
septicemia was lower in the RTx group than the non-RTx group, with an adjusted hazard ratio of 0.73 [95% confidence interval (CI) = 0.64-0.84, P < 0.001]. In addition, we observed insignificantly lower intensive care unit (ICU) admission rate (35.8% vs. 39.8%) and lower 30-day all-cause mortality rate (17.2% vs. 18.5%) in the RTx group than the non-RTx group. However, the mean cost for
septicemia in the RTx group was insignificantly higher than the non-RTx group (7175 vs. 6421 USD, P = 0.39).RTx recipients had a significantly reduced risk of developing
septicemia compared to the propensity-matched non-RTx
ESRD patients. The ICU admission and 30-day all-cause mortality rates also slightly decreased in RTx recipients but without statistical significance.