Influence of Dialysis Duration and Modality on Kidney Transplant Outcomes

Resende, Luís; Guerra, J.; Santana, Alice; Mil-Homens, C.; Abreu, Fernando; Costa, António Gomes da

doi:10.1016/j.transproceed.2009.01.063

Cited by 36 publications

(29 citation statements)

References 11 publications

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“…Several studies suggested that pretransplantation dialysis modality affects patients' long-term (such as mortality and graft failure) and short-term (such as delayed graft function) outcomes (2)(3)(4)(5)(6)(7)(8). However, others have been unable to show any relationship of pretransplant dialysis modality on post-transplant outcomes (9)(10)(11)(12). The two largest studies using national datasets before the 21st century yielded conflicting results.…”

Section: Introductionmentioning

confidence: 99%

“…Second, the previous studies are based on data in the late 20th century when the immunosuppressive protocols and drugs were significantly different (for instance, mycophenolate-mofetil was not available). Third, the most recent studies, analyzing data after 2000, have been rather small and mostly negative (no difference in outcomes), which might be a consequence of the inadequate statistical power (11,12). Fourth, none of these studies performed subgroup analysis to verify the validity of the associations across diverse subgroups of patients.…”

Section: Introductionmentioning

confidence: 99%

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Dialysis Modality and Outcomes in Kidney Transplant Recipients

Molnar

Mehrotra

Duong³

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The influence of pretransplant dialysis modality on post-transplant outcomes is not clear. This study examined associations of pretransplant dialysis modality with post-transplant outcomes in a large national cohort of kidney transplant recipients.Design, setting, participants, & measurements Linking the 5-year patient data of a large dialysis organization to the Scientific Registry of Transplant Recipients, 12,416 hemodialysis and 2092 peritoneal dialysis patients who underwent first kidney transplantation were identified. Mortality or graft failure and delayed graft function risks were estimated by Cox regression (hazard ratio) and logistic regression (odds ratio), respectively.Results Recipients treated with peritoneal dialysis pretransplantation had lower (21.9/1000 patient-years [95% confidence interval: 18.1-26.5]) crude all-cause mortality rate than those recipients treated with hemodialysis (32.8/1000 patient-years [30.8-35.0]). Pretransplant peritoneal dialysis use was associated with 43% lower adjusted all-cause and 66% lower cardiovascular death. Furthermore, pretransplant peritoneal dialysis use was associated with 17% and 36% lower unadjusted death-censored graft failure and delayed graft function risk, respectively. However, after additional adjustment for relevant covariates, pretransplant peritoneal dialysis modality was not a significant predictor of death-censored graft failure delayed graft function, respectively. Similar trends were noted on analyses using a propensity score matched cohort of 2092 pairs of patients. ConclusionsCompared with hemodialysis, patients treated with peritoneal dialysis before transplantation had lower mortality but similar graft loss or delayed graft function. Confounding by residual selection bias cannot be ruled out.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dialysis Modality and Outcomes in Kidney Transplant Recipients

Molnar

Mehrotra

Duong³

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…Dialysis therapy in a patient's history is an important cardiovascular risk factor [8] and has a significant impact on patient survival [9]. Four additional studies have suggested that time on dialysis is an important risk factor for all cause mortality [10,11], death with functioning graft [12] and graft loss [11,13]. This association was independent of the modality of the previous renal replacement therapy [11].…”

Section: Introductionmentioning

confidence: 99%

Association of pre-transplant dialysis duration with outcome in kidney transplant recipients: a prevalent cohort study

Remport¹,

Keszei

Vámos

et al. 2010

Int Urol Nephrol

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“…Previous studies analyzing the influence of pre‐transplant dialysis modalities on short‐ and long‐term kidney graft outcome have yielded controversial results (summarized in Table ). This may be due to differences in study design, including dissimilar donor‐related characteristics or unequal numbers of patients analyzed within each group . In addition, several studies included patients who had received both PD and HD in a sequential manner that were further categorized according to the modality used for the longest period or at the time of transplantation .…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, other studies have found better outcomes in patients receiving PD, including lower rates of delayed graft function (DGF) or shorter time on dialysis . Finally, some authors have reported no significant differences between both dialysis modalities in terms of the risk of DGF, acute tubular necrosis, graft rejection, infection, thrombosis, NODAT, or graft and patient survival …”

Section: Introductionmentioning

confidence: 98%

Pre‐transplant dialysis modality does not influence short‐ or long‐term outcome in kidney transplant recipients: analysis of paired kidneys from the same deceased donor

Dipalma

Fernández‐Ruiz

Praga

et al. 2016

Clinical Transplantation

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Previous studies have reported contradictory results regarding the effect of pre-transplant dialysis modality on the outcomes after kidney transplantation (KT). To minimize the confounding effect of donor-related variables, we performed a donor-matched retrospective comparison of 160 patients that received only one modality of pre-transplant dialysis (peritoneal dialysis [PD] and hemodialysis [HD] in 80 patients each) and that subsequently underwent KT at our center between January 1990 and December 2007. Cox regression models were used to evaluate the association between pre-transplant dialysis modality and primary study outcomes (death-censored graft survival and patient survival). To control for imbalances in recipient-related baseline characteristics, we performed additional adjustments for the propensity score (PS) for receiving pre-transplant PD (versus HD). There were no significant differences according to pre-transplant dialysis modality in death-censored graft survival (PS-adjusted hazard ratio [aHR]: 0.65; 95% confidence interval [95% CI]: 0.25-1.68) or patient survival (aHR: 0.58; 95% CI: 0.13-2.68). There were no differences in 10-year graft function or in the incidence of post-transplant complications either, except for a higher risk of lymphocele in patients undergoing PD (odds ratio: 4.31; 95% CI: 1.15-16.21). In conclusion, pre-transplant dialysis modality in KT recipients does not impact short- or long-term graft outcomes or patient survival.

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Influence of Dialysis Duration and Modality on Kidney Transplant Outcomes

Cited by 36 publications

References 11 publications

Dialysis Modality and Outcomes in Kidney Transplant Recipients

Dialysis Modality and Outcomes in Kidney Transplant Recipients

Association of pre-transplant dialysis duration with outcome in kidney transplant recipients: a prevalent cohort study

Pre‐transplant dialysis modality does not influence short‐ or long‐term outcome in kidney transplant recipients: analysis of paired kidneys from the same deceased donor

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