Kidney Transplant Outcomes Unaffected by Dialysis Modality
Patient and graft survival are similar for patients who were on hemodialysis and peritoneal dialysis prior to transplantation, study finds.
Choice of dialysis modality—hemodialysis (HD) or peritoneal dialysis (PD)—prior to kidney transplantation does not affect transplant outcomes, according to a study.
Following receipt of kidneys from donors after cardiac death, patients who previously had been on PD or HD had similar rates of complications and patient, graft, and death-censored graft survival, Xiajing Che, MD, of Shanghai Jiao Tong University in Shanghai, China, and colleagues reported in BMC Nephrology.
The authors noted there is continued controversy regarding pre-transplant dialysis modality, with some data suggesting increased risks of early graft failure in PD patients. Recent studies show equivalent transplant outcomes for HD and PD, and others indicate better outcomes for PD patients with respect to patient survival, graft function, delayed graft function.
To help clarify matters, Dr Che and colleagues conducted a prospective study that included 104 HD patients and 98 PD patients who underwent their first kidney transplant, as well as 5 patients who underwent pre-emptive kidney transplantation. The HD and PD groups were well matched regarding demographic and baseline characteristics, the investigators stated. The follow-up duration following transplantation was 12.5 and 12 months in the HD and PD groups, respectively.
The HD and PD groups did not differ significantly in the rates of delayed graft function (18.3% vs 16.3%, respectively), patient survival (96.2% vs 96.9%), graft survival (93.3% vs 93.9%), or death-censored graft survival (97.1% vs 96.9%). No deaths or graft failures occurred in the pre-emptive transplant patients.
In the addition, the groups had similar rates of acute rejection and surgical complications, and infection.
Che X, Yang X, Yan J, et al. Effects of pretransplant peritoneal vs hemodialysis modality on outcome of first kidney transplantation from donors after cardiac death. BMC Nephrol. 2018;19:235.