Comparison of Peritoneal Dialysis and Hemodialysis After Kidney Transplant Failure

Kang, Guogui; Jang, Mun; Hwang, Eunah; Park, S.B.; Han, Shu

doi:10.1016/j.transproceed.2013.08.035

Cited by 13 publications

(8 citation statements)

References 14 publications

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“…USA Renal Data System and the Canadian Organ Replacement Register data indicate that the risk of mortality in patients after allograft loss is three times higher than that of patients maintaining transplant function [24,25]. The clinical characteristics of patients on dialysis after allograft failure often differ from those of transplant-naïve patients, with studies reporting kidney function declines, and reduced hemoglobin, lower serum albumin, and increased C-reactive protein levels in these patients [26,27]. Also, the use of immunosuppression therapy further contributes to nephrotoxicity and the risk of infections in this cohort [28].…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Meng

et al. 2021

Renal Failure

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Purpose: The influence of prior failed kidney transplants on outcomes of peritoneal dialysis (PD) is unclear. Thus, we conducted a systematic review and meta-analysis to compare the outcomes of patients initiating PD after a failed kidney transplant with those initiating PD without a prior history of kidney transplantation. Methods: We searched PubMed, Embase, CENTRAL, and Google Scholar databases from inception until 25 November 2020. Our meta-analysis considered the absolute number of events of mortality, technical failures, and patients with peritonitis, and we also pooled multi-variable adjusted hazard ratios (HR). Results: We included 12 retrospective studies. For absolute number of events, our analysis indicated no statistically significant difference in technique failure [RR, 1.14; 95% CI, 0.80-1.61; I 2 ¼52%; p ¼ 0.48], number of patients with peritonitis [RR, 1.13; 95% CI, 0.97-1.32; I 2 ¼5%; p ¼ 0.11] and mortality [RR, 1.00; 95% CI, 0.67-1.50; I 2 ¼63%; p ¼ 0.99] between the study groups. The pooled analysis of adjusted HRs indicated no statistically significant difference in the risk of technique failure [HR, 1.25; 95% CI, 0.88-1.78; I 2 ¼79%; p ¼ 0.22], peritonitis [HR, 1.04; 95% CI, 0.72-1.50; I 2 ¼76%; p ¼ 0.85] and mortality [HR, 1.24; 95% CI, 0.77-2.00; I 2 ¼66%; p ¼ 0.38] between the study groups. Conclusion: Patients with kidney transplant failure initiating PD do not have an increased risk of mortality, technique failure, or peritonitis as compared to transplant-naïve patients initiating PD. Further studies are needed to evaluate the impact of prior and ongoing immunosuppression on PD outcomes.

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Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Meng

et al. 2021

Renal Failure

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“…PD treatment offers numerous advantages [ 22 , 23 ], however only 7 to 10% of end-stage renal disease patients are treated with PD [ 2 ]. This reflects, at least in part, the clinicians’ fear of technical failure [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Outcome of polycystic kidney disease patients on peritoneal dialysis: Systematic review of literature and meta-analysis

et al. 2018

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BackgroundPolycystic kidney disease (PKD) is the most frequent hereditary cause of chronic kidney disease. Peritoneal dialysis (PD) is often avoided for patients with PKD because of the suspected risk of mechanical and infectious complications. Only a few studies have analyzed the outcome of PKD patients on PD with sometimes conflicting results. The purpose of this meta-analysis was to investigate outcomes of patients with PKD treated by PD.MethodsA systematic review and meta-analysis were performed examining all studies which included “Polycystic kidney disease” and “Peritoneal dialysis” in their titles, excluding commentaries, letters to the authors and abstracts. PubMed, Embase, Google scholar and Scopus were searched to December 31st 2017. The primary outcome was overall patient survival. Additional outcomes were PD technique survival, incidence of peritonitis and incidence of abdominal wall hernia.Results9 studies published between 1998 and 2016 were included for analysis with a total of 7,197 patients including 882 PKD patients. Overall survival of PKD patients was found to be better compared to non-PKD patients (HR = 0.70 [95% CI, 0.54–0.92]). There were no statistical differences between PKD and non-PKD patients in terms of peritonitis (OR = 0.86 [95% CI, 0.66–1.12]) and technical survival (HR = 0.98 [95% CI, 0.83–1.16]). There was an increased risk of hernia in PKD patients (OR = 2.28 [95% CI, 1.26–4.12]).ConclusionsPKD is associated with a better global survival, an increased risk of abdominal hernia, but no differences in peritonitis rate or technical survival were found. PD is a safe dialysis modality for PKD patients. Properly designed controlled studies are needed to determine whether all PKD patients are eligible for PD or whether some specific criteria should be determined.

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“…Graftını kaybetmiş hastalarda hangi diyaliz modalitesinin tercih edilmesi gerektiği konusunda net bir bilgi yoktur ancak yapılmış birçok çalışmada periton diyalizi (PD) ve hemodiyaliz (HD) arasında sağkalım açısından fark saptanmamıştır (20)(21)(22). 1995-2007 yılları arasında USRDS veri tabanında kayıtlı 16113 diyalize dönen renal allograft yetmezlikli hastalarda yapılmış bir çalışmada, PD'ne başlayan hastaların HD hastalarına göre ilk yıl içinde sağkalımlarının daha iyi olduğunu, ancak 2 yıldan sonra daha kötü sağkalıma sahip olduklarını, tüm sağkalım oranlarına bakıldığında ise benzer olduğu gösterilmiştir (23).…”

Section: Diyaliz Tedavisine Geri Dönüşunclassified

Management of Patients with a Failed Kidney Transplant

Yelken¹,

Akagun²,

Türkmen³

2016

Turk Neph Dial Transpl

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ÖzGraft kaybı sonrası diyalize dönen hastaların sayısı giderek artmaktadır. Bu hastaların morbidite ve mortalitesi, hiç transplantasyon olmamış hastalardan daha yüksektir. Bu hastalarla ilgili pek çok konunun belirsiz olması nedeniyle, yönetimleri oldukça zordur. Bu derlemede bu hastaların mortalitesi, diyalize başlama zamanı ve renal replasman tedavisi tercihi, immünosupresiflerin yönetimi, graft nefrektomi gerekliliği ve retransplantasyon hakında güncel önerilere yer verilmiş ve bir sonuca varılmaya çalışılmıştır.AnAhTAR sÖzcükleR: Graft kaybı, Diyalize yeniden başlama, Mortalite, İmmünosupresyon kesilmesi, Graft nefrektomi, Retansplantasyon ABsTRAcTThe number of patients with a failed allograft returning to dialysis increases over time. These patients have increased morbidity and mortality compared with their transplant-naive, incident dialysis patients. The management of these patients is more difficult as many issues are unclear. This review includes the current suggestions on mortality, dialysis reinitiation time, renal replacement therapy, and retransplantation. We aimed to reach a conclusion regarding these issues.

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Comparison of Peritoneal Dialysis and Hemodialysis After Kidney Transplant Failure

Cited by 13 publications

References 14 publications

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Outcome of polycystic kidney disease patients on peritoneal dialysis: Systematic review of literature and meta-analysis

Management of Patients with a Failed Kidney Transplant

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