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Paired Analysis of Outcomes After Kidney Transplantation in Peritoneal and Hemodialysis Patients.

Abstract：

BACKGROUND:The impact of dialysis modality before kidney transplantation (hemodialysis or peritoneal dialysis) on outcomes is not clear. In this study we retrospectively analyzed the impact of dialysis modality on posttransplant follow-up. METHODS:To minimize donor bias, a paired kidney analysis was applied. One hundred thirty-three pairs of peritoneal dialysis (PD) and hemodialysis (HD) patients were transplanted at our center between 1994 and 2016. Those who received kidneys from the same donor were included in the study. HD patients were significantly older (44 vs 48 years), but the Charlson Comorbidity Index was similar (3.12 vs 3.46) in both groups. The groups did not differ significantly with respect to immunosuppressive protocols and number of mismatches (2.96 vs 2.95). RESULTS:One-year patient (98% vs 96%) and graft (90% vs 93%) survival was similar in the PD and HD patient groups. The Kaplan-Meier curves of the patients and graft survival did not differ significantly. Delayed graft function (DGF) and acute rejection (AR) occurred significantly more often in the HD recipients. Graft vessel thrombosis resulting in graft loss occurred in 9 PD (6.7%) and 4 HD (3%) patients (P > .05). Serum creatinine concentration and estimated glomerular filtration rate (using the Modification of Diet in Renal Disease guidelines) showed no difference at 1 month, 1 year, and at final visit. On multivariate analysis, factors significantly associated with graft loss were graft vessel thrombosis, DGF, and graft function 1 month after transplantation. On univariate analysis, age, coronary heart disease, and graft loss were associated with death. Among these factors, only coronary heart disease (model 1) and graft loss were significant predictors of death on multivariate analysis. CONCLUSION:The long-term outcome for renal transplantation is similar in patients with PD and HD. These groups differ in some aspects, however, such as susceptibility to vascular thrombosis in PD patients, and to DGF and AR in HD patients.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Dębska-Ślizień A,Bobkowska-Macuk A,Bzoma B,Moszkowska G,Milecka A,Zadrożny D,Wołyniec W,Chamienia A,Lichodziejewska-Niemierko M,Król E,Śledziński Z,Rutkowski B

doi

10.1016/j.transproceed.2018.02.104

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

1646-1653

issue

6

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)30291-4

journal_volume

50

pub_type

杂志文章

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