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.