Pretransplant peritoneal dialysis relative to hemodialysis improves long-term survival of kidney transplant patients: a single-center observational study

López-Oliva, María O.; Rivas, Begoña; Pérez‐Fernández, Elia; Ossorio, Marta; Ros, Silvia Algaba; Chica, Carlos; Aguilar, Ana; Bajo, M. Auxiliadora; Escuín, Fernando; Hidalgo, Luis; Selgas, Rafael; Jiménez, Carlos

doi:10.1007/s11255-013-0521-0

Cited by 19 publications

(19 citation statements)

References 20 publications

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“…We had no significant differences in the incidence of AR, which is in line with recent studies [ 3 , 6 , 11 , 12 ]. This may be due to the availability of and rational novel immunosuppressive protocols nowadays.…”

Section: Discussionsupporting

confidence: 92%

“…Our results indicated both the immediate and long-term renal function, the serum creatinine and urine output, were similar between the HD and PD, consistent with other studies [ 6 , 11 ]. In our study, the baseline serum creatinine was higher in PD than HD patients.…”

Section: Discussionsupporting

confidence: 92%

“…Ischemic-reperfusion of donated kidney caused by postischemic acute tubular necrosis and interstitial inflammation results in DGF [ 19 ]. The PD patients has lower incidence of DGF in comparison with the HD [ 9 , 11 , 12 ]. This could be due to better hydration status and preservation of residual renal function (RRF) in PD patients [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…While the long-term graft failure and patient mortality remained similar. Some studies report PD had better patient survival, better quality of life, better nutritional status and fewer blood transfusions [ 9 – 11 ]. The differences might be associated with the different sample size and the follow-up time.…”

Section: Discussionmentioning

confidence: 99%

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Effects of pretransplant peritoneal vs hemodialysis modality on outcome of first kidney transplantation from donors after cardiac death

et al. 2018

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BackgroundThe effect of pretransplant peritoneal dialysis (PD) or hemodialysis (HD) modality on outcomes of kidney transplantation (KT) for end-stage renal disease (ESRD) is debatable. We evaluated the outcomes these modalities in KT from donor after cardiac death (DCD).MethodsA cohort of 251 patients on HD, PD or pre-emptive who underwent first KT from DCD between January 2014 and December 2016 were prospectively analyzed to compare for outcomes on recovery of renal function, complications as well as patient and graft survival. The patients were followed till August 2017. Data on 104 HD and 98 PD were available for final comparative outcome analysis, 5 pre-emptive were analyzed as the control group.ResultsBoth HD and PD group patients were well matched for demographic and baseline characteristics. The follow-up period was 12.5 (3.0, 22.0) months in HD and 12.0 (6.0, 20.0) months in PD patients. Post-transplant renal functions between the two groups showed no differences. Among PD patients, 16 (16.3%) suffered delayed graft function, versus 19 (18.3%) in HD, with no statistical differences (p = 0.715). Complications of acute rejection, infections were comparable between the groups. The patient survival, graft survival and death-censored graft survival were similar for HD and PD after adjusting for other multiple risk factors.ConclusionsOur results indicate that outcome of first KT from DCD is not affected by pretransplant dialysis modality of PD or HD in aspects of recovery of renal function, complications as well as patient and graft survival.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of pretransplant peritoneal vs hemodialysis modality on outcome of first kidney transplantation from donors after cardiac death

et al. 2018

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“…Interestingly, as suggested by experimental studies, we found that preserved daily urinary volume rather than type of dialysis itself was a risk factor for primary nonfunction. In fact, a recent single‐center study suggests that the pretransplant dialysis modality does not influence long‐term graft loss risk . However, large observational studies indicate that peritoneal dialysis patients may experience increased rates of graft thrombosis and early graft failure .…”

Section: Discussionmentioning

confidence: 99%

Residual urinary volume is a risk factor for primary nonfunction in kidney transplantation

et al. 2015

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SummaryPrimary nonfunction is a severe complication after kidney transplantation. Residual renal function could be a risk factor for this complication in the current era of kidney transplantation from extended criteria donors (ECD). This is a singlecenter case-control study. Between 2000 and 2012, 1112 patients received a kidney transplant from a deceased donor. We identified 56 cases of early graft loss (kidney that never recover renal function and/or graft thrombosis <48 h after kidney transplantation). As controls we used patients receiving the contralateral kidney. Donor age was 55 AE 17 years with 57% fulfilling ECD criteria. Among the 56 cases, 14 were due to vascular rejection and 42 to primary nonfunction. Risk factors for early graft loss due to vascular rejection were previous transplant, time on dialysis, and HLA sensitization. Risk factors for primary nonfunction were first transplant, short period on dialysis, mainly peritoneal dialysis, and a residual urinary volume ≥500 ml/24 h. Conditional logistic regression analysis showed that residual urinary volume (OR = 20.01) rather than the dialysis modality was a major risk factor for primary nonfunction. In conclusion, residual urinary volume seems to be a risk factor for primary nonfunction in the current era of kidney transplantation.

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Association Between Pretransplant Dialysis Modality and Kidney Transplant Outcomes

et al. 2022

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ImportanceThe benefits and disadvantages of different pretransplant dialysis modalities and their posttransplant outcomes remain unclear in contemporary kidney transplant care.ObjectiveTo summarize the available evidence of the association of different pretransplant dialysis modalities, including hemodialysis and peritoneal dialysis (PD), with posttransplant outcomes.Data SourcesMEDLINE, Embase, PubMed, Cochrane Library, Scopus, CINAHL, and gray literature were searched from inception to March 18, 2022 (updated to April 1, 2022), for relevant studies and with no language restrictions.Study SelectionRandomized clinical trials and nonrandomized observational (case-control and cohort) studies that investigated the association between pretransplant dialysis modality and posttransplant outcomes regardless of age or donor sources (living or deceased) were abstracted independently by 2 reviewers.Data Extraction and SynthesisFollowing Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology reporting guidelines, 2 reviewers independently extracted relevant information using a standardized approach. Random-effects meta-analysis was used to estimate pooled adjusted hazard ratio (HR) or odds ratio and 95% CI.Main Outcomes and MeasuresPrimary outcomes included all-cause mortality, overall graft failure, death-censored graft failure, and delayed graft function. Secondary outcomes included acute rejection, graft vessel thrombosis, oliguria, de novo heart failure, and new-onset diabetes after transplant.ResultsThe study analyzed 26 nonrandomized studies (1 case-control and 25 cohort), including 269 715 patients (mean recipient age range, 14.5-67.0 years; reported proportions of female individuals, 29.4%-66.9%) whose outcomes associated with pretransplant hemodialysis vs pretransplant PD were compared. No significant difference, with very low certainty of evidence, was observed between pretransplant PD and all-cause mortality (13 studies; n = 221 815; HR, 0.92 [95% CI, 0.84-1.01]; P = .08) as well as death-censored graft failure (5 studies; n = 96 439; HR, 0.98 [95% CI, 0.85-1.14]; P = .81). However, pretransplant PD was associated with a lower risk for overall graft failure (10 studies; n = 209 287; HR, 0.96 [95% CI, 0.92-0.99]; P = .02; very low certainty of evidence) and delayed graft function (6 studies; n = 47 118; odds ratio, 0.73 [95% CI, 0.70-0.76]; P &lt; .001; low certainty of evidence). Secondary outcomes were inconclusive due to few studies with available data.Conclusions and RelevanceResults of the study suggest that pretransplant PD is a preferred dialysis modality option during the transition to kidney transplant. Future studies are warranted to address shared decision-making between health care professionals, patients, and caregivers as well as patient preferences.

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Pretransplant peritoneal dialysis relative to hemodialysis improves long-term survival of kidney transplant patients: a single-center observational study

Abstract: Pretransplantation dialysis modality is associated with long-term patient survival, with outcomes favoring peritoneal dialysis over hemodialysis. However, the pretransplant dialysis modality does not influence long-term graft loss risk.

Cited by 19 publications

References 20 publications

Effects of pretransplant peritoneal vs hemodialysis modality on outcome of first kidney transplantation from donors after cardiac death

Effects of pretransplant peritoneal vs hemodialysis modality on outcome of first kidney transplantation from donors after cardiac death

Residual urinary volume is a risk factor for primary nonfunction in kidney transplantation

Association Between Pretransplant Dialysis Modality and Kidney Transplant Outcomes

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