In a fascinating article from November's Journal of the American Society of Nephrology, researchers present data suggesting that patients returning to dialysis after a transplant fails experience improved survival if the kidney is removed. In this study, despite correction for comorbidities and socioeconomic factors, graft nephrectomy prolonged survival. One explanation of the results might be that nephrectomy removes an inflammatory stimulant and would allow complete withdrawal of immunosuppression and its risks. This finding is somewhat contradictory to current dogma which suggests that immunosuppression should be continued once returning to dialysis in order to preserve residual renal function. This study's finding would need to be reproduced with a prospective randomized trial to reduce bias but in the meantime, is quite compelling.