Peritoneal Dialysis Patients May Have Better Post-Transplant Survival

Meta-analysis suggests a 9% decreased 5-year mortality risk associated with pre-transplant peritoneal dialysis versus hemodialysis.
Meta-analysis suggests a 9% decreased 5-year mortality risk associated with pre-transplant peritoneal dialysis versus hemodialysis.

SAN DIEGO—Kidney transplant recipient survival rates at 5 years are better if the patients were on peritoneal dialysis rather than hemodialysis prior to transplantation, findings of a new meta-analysis presented at Kidney Week suggest.

A team at the University of Wisconsin in Madison led by Micah R. Chan, MD, MPH, analyzed data from 16 studies reporting 5-year patient mortality after kidney transplantation. Six studies included an adjusted risk ratio. Pooled data from these studies showed that pre-transplant PD was associated with an 11% decreased 5-year mortality risk compared with pre-transplant HD. Results showed no significant difference in 5-year graft survival between pre-transplant PD and HD.

In addition, unadjusted analyses showed that pre-transplant PD versus HD was associated with a decreased risk for delayed graft function.

“These results suggest that PD may be the preferred dialysis modality for patients expected to receive a [kidney] transplant,” the researchers concluded in a poster presentation.

Dr. Chan's group acknowledged that their study was limited by the small number of studies with the same time points for mortality and graft survival, high heterogeneity, and unadjusted data reporting for delayed graft function.

The authors commented that more consistent data collection from transplant programs, including standardized outcome report, “could lead to further understanding of the benefits conferred by pre-transplant dialysis modality and help improve post-transplant outcomes.”

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