Dialysis as a bridge therapy to renal transplantation: comparison of graft outcomes according to mode of dialysis treatment.

BACKGROUND: Renal transplantation is the ideal renal replacement therapy in patients with end-stage renal disease. It was unclear whether a difference in dialysis modality influences outcomes after kidney transplantation. Therefore, we evaluated the influence of dialysis modality.
METHODS: We compared various clinical and laboratory parameters of 70 peritoneal dialysis (PD) and 180 hemodialysis (HD) patients (n=250), including 91 females and an overall age 36.7±9.7 years who underwent transplantation between 2000 and 2008 to evaluate factors affecting delayed graft function (DGF) and of transplant graft failure.
RESULTS: Overall graft survival was 82% at 3 and 75% at 5 years. Among HD patients, 16% displayed DGF, versus 12% of PD patients. Multivariate analysis showed that factors affecting DGF were: mode of dialysis (relative risk [RR]=1.39, 95% confidence interval (CI): 1.35-1.43; P<.01); parathyroid hormone (RR=0.32, 95% CI: 0.30-0.34, P<.05), C-reative protein (RR=1.03, 95% CI: 0.97-1.09; P<.05), hemoglobin levels (RR=.75, 95% CI: 0.72-0.79; P<.05). At 3 and 5 years follow-up, PD patients' showed fewer graft failures than HD patients (14% vs 20%; P<.05 and 17% vs 28%; P<.05).
CONCLUSION: Early graft function rates were better for PD than for HD patients. Inflammation and anemia should be carefully investigated and corrected to achieve better graft function.