SUN-329 RETURN TO DIALYSIS AFTER KIDNEY TRANSPLANTATION : ABOUT 13 CASES

Abstract

The return to dialysis after transplant loss is an emerging problem in dialysis centers. The objective of this study is to determine the conditions ofinitial treatment in dialysis of patients who have lost graft function. This study involved 13 renal transplant patients who started or restarted a chronic dialysis program in the renal nephrology and renal transplant department at Sahloul Hospital. We collected biological and epidemiological clinical data from all patients during the transplantation period and during dialysis. Thirteen (13) patients were enrolled: 8 men (61%) and 5 women (39%); all these patients were dialyzed before renal transplantation for an average duration of 39.5 months, 10 of whom were on hemodialysis (HD) and 3 peritoneal dialysis (DP). At the time of renal transplantation, patients were, on average 43 years old. The 13 recipients had a living donation, with a functional kidney transplant lasting 6 to 66 months, with an average of 28.5 months. Kidney transplant recipients, on average of 28 years old when they returned to dialysis. 9 patients were hypertensive, one patient had diabetes, one patient had kaposi sarcoma and 2 patients had heart disease. 10 patients started dialysis with HD. 9 patients started emergency dialysis with positioning of a central catheter. Dialysis in 7 patients and preexisting arterio-venous fistula in 2 patients. Mean serum creatinine pre-dialysis was 889 μmol /L. The average urea was 37 mmol /L. The mean hemoglobin, albumin levels were 7.4 g / dl and 32 g /L respectively. Serum calcium was 1.88 mmol/L and there was mild hyperkalemia and hyperphosphatemia. Four patients received between 3 and 4 treatments for hypertension, while 5 received 2 but did not allow normalization of blood pressure in the vast majority of cases. These data may provoke critical reflection among practitioners in charge of kidney transplant patients, as regards the management of the transition period from renal transplantation to dialysis.