Peritoneal Dialysis for Delayed Graft Function After Kidney Transplantation: To Do or Not to Do?

Issa, Naim; Lakhani, Laila Saleem

doi:10.1016/j.ekir.2021.04.008

“…In a recent commentary on a case–control study by Gardezi et al [ 47 ], Issa and Lakhani [ 48 ] proposed an algorithm for the management of peritoneal dialysis catheter in patients undergoing renal transplantation. These experts suggest leaving peritoneal dialysis catheters in place only when (1) delayed graft function is highly expected and (2) peritoneum breach as well as catheter-related infection is absent.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the methods to predict delayed graft function in individual patients are still a matter of debate. Issa and Lakhani propose the use of Kidney Donor Profile Index (KDPI) along with several other predictive factors (such as long cold ischemia time and recipient’s history of obesity, diabetes mellitus, prior allosensitization, long dialysis vintage, and waiting time) [ 48 ]. However, predictive models for delayed graft function are not well clinically validated.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal dialysis catheter removal at the time or after kidney transplantation: a systematic review and meta-analysis

Zawistowski

¹

,

Nowaczyk

²

,

Domagała

³

2022

Langenbecks Arch Surg

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Purpose An increasing number of patients treated with peritoneal dialysis eventually undergo kidney transplantation. Owing to opposing reports, we aimed to find evidence about the best time for peritoneal dialysis catheter removal in transplant patients. Methods We conducted a systematic review and random effects meta-analysis of non-randomized studies of intervention comparing patients with peritoneal dialysis catheters left in place or removed during kidney transplantation in regard to the need for dialysis and occurrence of catheter-related complications. We searched (last update on 8 December 2021) PubMed, Embase, Scopus, and Web of Science for eligible studies. ROBINS-I tool and funnel plot asymmetry analysis were used to assess the quality of included articles. Results Eight observational studies were evaluated. Five of them, which involved 338 patients, were included in a meta-analysis. All were at moderate to serious risk of bias. The odds of needing dialysis are more than twice as high for patients with peritoneal dialysis catheters left in situ (pooled odds ratio, 2.21; 95% confidence interval [CI], 1.03 to 4.73; I2 = 0%). No statistically significant difference was noted when adult and pediatric subgroups were compared (Q = 0.13, P = .720). More individuals with catheters left in place required dialysis (pooled prevalence, 20.9%; 95% CI, 13.6 to 30.7%; I2 = 59% vs. 12.4%; 95% CI, 5.6 to 25.2%; I2 = 0%) and experienced catheter-related infections. Conclusion Available evidence is scarce. Unless new data from a randomized controlled trial are available, the dilemma of peritoneal dialysis catheter removal cannot be solved. Trial registration PROSPERO Protocol ID: CRD42020207707. Graphical abstract

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“…У будь-якому випадку запропоновано надавати перевагу ПД у посттрансплантаційному періоді, адже ГД має вищі інфекційні ризики через наявність центрального венозного катетера, що потенційно є джерелом більшої інфекційної небезпеки для пацієнтів, які знаходяться на імуносупресії, та небезпеки кровотечі [25].…”

unclassified

Renal replacement therapy: does the patient have a choice?

Ivanov

¹

2023

KIDNEYS

1

0

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Nowadays there is an emerging problem with renal replacement therapy in the world. Its main methods include dialysis and renal transplantation. However, many regions in the world do not have access to one or more therapy methods due to numerous economic, social, and other factors. Hemodialysis and peritoneal dialysis are shown to be equally efficient, however, it may be difficult to choose one. For each patient who is faced with the choice of a method of renal replacement therapy, the question is which way to choose. The moral and social aspects of such a choice are quite complex. Therefore, the role of a doctor, in addition to the qualified performance of renal replacement therapy, is largely advisory and requires patience and understanding of a patient. It is important to raise the awareness of patients and the level of medical staff education as well as provide equal access to all renal replacement therapy types in the world.

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Renal replacement therapy: does the patient have a choice?

Ivanov

¹

2022

KIDNEYS

0

View full text Add to dashboard Cite

Nowadays there is an emerging problem with renal replacement therapy in the world. Its main methods include dialysis and renal transplantation. However, many regions in the world do not have access to one or more therapy methods due to numerous economic, social, and other factors. Hemodialysis and peritoneal dialysis are shown to be equally efficient, however, it may be difficult to choose one. For each patient who is faced with the choice of a method of renal replacement therapy, the question is which way to choose. The moral and social aspects of such a choice are quite complex. Therefore, the role of a doctor, in addition to the qualified performance of renal replacement therapy, is largely advisory and requires patience and understanding of a patient. It is important to raise the awareness of patients and the level of medical staff education as well as provide equal access to all renal replacement therapy types in the world.

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Peritoneal Dialysis for Delayed Graft Function After Kidney Transplantation: To Do or Not to Do?

Cited by 4 publications

References 7 publications

Peritoneal dialysis catheter removal at the time or after kidney transplantation: a systematic review and meta-analysis

Peritoneal dialysis catheter removal at the time or after kidney transplantation: a systematic review and meta-analysis

Renal replacement therapy: does the patient have a choice?

Renal replacement therapy: does the patient have a choice?

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