CAPD--a risk factor in renal transplantation?

Theoretical considerations suggest that patients undergoing continuous ambulatory peritoneal dialysis (CAPD) may fare less well after renal transplantation than their haemodialysed (HD) counterparts. Review of 121 consecutive cadaveric renal allografts performed in this centre indicate this to be the case with graft survival rates at 1 year of 63.5 per cent in the HD group compared with 35.5 per cent in the CAPD-treated patients. This difference appeared to be independent of the duration of dialysis and, although a significant blood transfusion effect was seen in the HD group, no such trend was evident in the CAPD group. Studies of T cell subsets (using monoclonal antibodies) in the two groups suggests that, in part at least, the differences in graft survival rates may be attributable to the maintenance or restoration of immunological integrity in the CAPD group.