Ting Yan1, Wenhan Peng2,3,4, Junhao Lv1,5, Jianyong Wu1,5,6, Jianghua Chen1,5,6. 1. Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China. 2. Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China, 1198027@zju.edu.cn. 3. Key Laboratory of Nephropathy, Hangzhou, China, 1198027@zju.edu.cn. 4. National Key Clinical Department of Kidney Diseases, Hangzhou, China, 1198027@zju.edu.cn. 5. Key Laboratory of Nephropathy, Hangzhou, China. 6. National Key Clinical Department of Kidney Diseases, Hangzhou, China.
Abstract
BACKGROUND/AIMS: Hemodialysis (HD) or peritoneal dialysis (PD) is an important renal replacement method in patients with delayed graft function (DGF) after kidney transplantation; however, it is not clear which dialysis modality is superior. This study determined the impact of different dialysis modalities on patients with DGF. METHODS: It was a single-center, retrospective and descriptive study. We performed 673 kidney transplants from donors after cardiac death (DCD) between January 2010 and December 2016 at our center and 138 (20.5%) recipients developed DGF after transplantation. We classified the recipients into two groups according to post-transplant dialysis: DGF-HD (n=96) and DGF-PD (n=42). We analyzed the outcomes of the different dialysis modalities 30 days and 1 year post-transplantation. RESULTS: There were no differences in baseline factors between patients with post-transplant HD (n = 96) or PD (n = 42). There were 10 patients with conversion from PD to HD during DGF. The DGF-PD patients had a higher rate of treatment failure than the DGF-HD patients (23.8% vs. 0%, p < 0.001), peritonitis (7.1% vs. 0%, p = 0.027), and longer duration of dialysis dependence (10.5 vs. 9 days, p = 0.003). There was no statistically significant difference between both groups with respect to acute rejection, hemorrhage, and patient and graft survival at 1 year. CONCLUSION: In renal transplant recipients with DGF, post-transplant PD led to increased treatment failure. PD did not result in rapid recovery of transplanted renal function, and had a high probability of peritonitis.
BACKGROUND/AIMS: Hemodialysis (HD) or peritoneal dialysis (PD) is an important renal replacement method in patients with delayed graft function (DGF) after kidney transplantation; however, it is not clear which dialysis modality is superior. This study determined the impact of different dialysis modalities on patients with DGF. METHODS: It was a single-center, retrospective and descriptive study. We performed 673 kidney transplants from donors after cardiac death (DCD) between January 2010 and December 2016 at our center and 138 (20.5%) recipients developed DGF after transplantation. We classified the recipients into two groups according to post-transplant dialysis: DGF-HD (n=96) and DGF-PD (n=42). We analyzed the outcomes of the different dialysis modalities 30 days and 1 year post-transplantation. RESULTS: There were no differences in baseline factors between patients with post-transplant HD (n = 96) or PD (n = 42). There were 10 patients with conversion from PD to HD during DGF. The DGF-PDpatients had a higher rate of treatment failure than the DGF-HDpatients (23.8% vs. 0%, p < 0.001), peritonitis (7.1% vs. 0%, p = 0.027), and longer duration of dialysis dependence (10.5 vs. 9 days, p = 0.003). There was no statistically significant difference between both groups with respect to acute rejection, hemorrhage, and patient and graft survival at 1 year. CONCLUSION: In renal transplant recipients with DGF, post-transplant PD led to increased treatment failure. PD did not result in rapid recovery of transplanted renal function, and had a high probability of peritonitis.
Authors: Ali I Gardezi; Brenda Muth; Adil Ghaffar; Fahad Aziz; Neetika Garg; Maha Mohamed; David Foley; Dixon Kaufman; Arjang Djamali; Didier Mandelbrot; Sandesh Parajuli Journal: Kidney Int Rep Date: 2021-04-17