Abstract
BackgroundThe effect of pretransplant peritoneal dialysis (PD) or hemodialysis (HD) modality on outcomes of kidney transplantation (KT) for end-stage renal disease (ESRD) is debatable. We evaluated the outcomes these modalities in KT from donor after cardiac death (DCD).MethodsA cohort of 251 patients on HD, PD or pre-emptive who underwent first KT from DCD between January 2014 and December 2016 were prospectively analyzed to compare for outcomes on recovery of renal function, complications as well as patient and graft survival. The patients were followed till August 2017. Data on 104 HD and 98 PD were available for final comparative outcome analysis, 5 pre-emptive were analyzed as the control group.ResultsBoth HD and PD group patients were well matched for demographic and baseline characteristics. The follow-up period was 12.5 (3.0, 22.0) months in HD and 12.0 (6.0, 20.0) months in PD patients. Post-transplant renal functions between the two groups showed no differences. Among PD patients, 16 (16.3%) suffered delayed graft function, versus 19 (18.3%) in HD, with no statistical differences (p = 0.715). Complications of acute rejection, infections were comparable between the groups. The patient survival, graft survival and death-censored graft survival were similar for HD and PD after adjusting for other multiple risk factors.ConclusionsOur results indicate that outcome of first KT from DCD is not affected by pretransplant dialysis modality of PD or HD in aspects of recovery of renal function, complications as well as patient and graft survival.
Highlights
The effect of pretransplant peritoneal dialysis (PD) or hemodialysis (HD) modality on outcomes of kidney transplantation (KT) for end-stage renal disease (ESRD) is debatable
Peritoneal dialysis (PD), hemodialysis (HD) and kidney transplantation (KT) are three main renal replacement therapies for end-stage renal disease (ESRD) and KT with advances in technology and immunosuppressants is preferred for the recovery of renal function and the
Pre-emptive kidney transplantation (PKT) group was analyzed as the control group
Summary
The effect of pretransplant peritoneal dialysis (PD) or hemodialysis (HD) modality on outcomes of kidney transplantation (KT) for end-stage renal disease (ESRD) is debatable. Peritoneal dialysis (PD), hemodialysis (HD) and kidney transplantation (KT) are three main renal replacement therapies for end-stage renal disease (ESRD) and KT with advances in technology and immunosuppressants is preferred for the recovery of renal function and the. More studies are needed to clarify the identical or even better function of PD compared with HD. We conducted this prospective cohort study to compare the effects of pretransplant HD vs PD on outcomes of renal function, post-transplant complications, graft as well as patient survival of first KT from Donor after cardiac death (DCD)
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