DO DIALYSIS METHODS AFFECT THE KIDNEY GRAFT RECIPIENTS OUTCOME ?

Abstract

P338 The role of pretransplant dialysis method on kidney transplant (kTx) outcomes is still debated. We examined the influence of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) treatment on kidney graft function, acute rejection, complication occurrence and patient/graft survival. The study included pairs of patients, one HD and one CAPD treated, who received a cadaveric renal transplant from the same donor, so as the effects of donor factors would not interfere with the results. A total of 80 patients (pts) transplanted between 1996 and 2003 was analyzed. A group of 40 patients was treated with CAPD for 24.5 months before kTx, and a second group of 40 patients was treated with HD for 32.0 months. In the CAPD group 79 % of patients, while in the HD group 81,5 % of patients were treated with cyclosporine, and the remaining patients with tacrolimus. Clinical characteristics such as age, gender, cause of renal failure, PRA, HLA mismatches were comparable between the two groups. The delayed graft function occurred less frequently in CAPD patients (13% vs. 36%) and lasted for shorter period (6,29 ± 5,9 vs. 9,05 ± 11,46) than in HD group. The acute rejection episodes (AR) occurred in 26% of patients CAPD group and 32% in HD group. Serum creatinine concentrations 12 months after kTx were comparable in CAPD and HD groups (1.4±0.5 vs. 1.5±0.7 mg/dl). The incidence of bacterial and viral infections was similar among CAPD and HD pts (87% vs. 97%). Sepsis and grafts vein thrombosis were the cause of graft failure in CAPD treated patients whereas myocardial infarction and patients death in HD group. One-year graft and patient survival was the same in both groups (94% vs. 97%) (NS). Conclusions: Our research revealed lower incidence of delayed graft function in patients treated with peritoneal dialysis before transplantation in comparison with hemodialysed patients. However, there were no differences in the incidence of acute rejection, graft survival and infections after transplantation procedure Renal transplant outcome does not depend on pretransplant dialysis method.