Peritoneal dialysis versus hemodialysis in patients with delayed graft function

Thomson, Benjamin; Moser, Mike; Marek, Caitlyn; Bloch, Michael; Weernink, Corinne; Shoker, Ahmed; Luke, Patrick

doi:10.1111/ctr.12266

Cited by 13 publications

(18 citation statements)

References 28 publications

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“…The reported frequency of DGF of donors after cardiac death (DCD) kidney transplants greatly varies worldwide (10%–61%) [1-4]. Since 2010, DCD have become the major source of kidneys used in transplants in China.…”

Section: Introductionmentioning

confidence: 99%

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Hemodialysis or Peritoneal Dialysis, Which Is Better for Patients with Delayed Graft Function?

Yan

Wei

et al. 2018

Kidney Blood Press Res

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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.

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Section: Introductionmentioning

confidence: 99%

“…At present, only one study has shown the effect of post-transplant dialysis modality in renal transplant recipients with DGF on 1-year outcomes. It was concluded that using PD increased the risk of wound infection/leakage and required less dialysis time post-operatively [4], but the failure rates of HD and PD treatment were not analyzed.…”

Section: Introductionmentioning

confidence: 99%

Hemodialysis or Peritoneal Dialysis, Which Is Better for Patients with Delayed Graft Function?

Yan

Wei

et al. 2018

Kidney Blood Press Res

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“…One of the main concerns regarding the early removal of the PDC is delayed graft function or PNF, and the consequent need for dialysis. Although PD is feasible after KT, an increased risk of wound infection and leakage has been reported (6,7,11). Our center's policy is to avoid PD early after KT in order to decrease the risk of these complications, and whenever dialysis support is required, we place a central venous catheter (CVC), even though blood stream infections might also pose a threat.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Peritoneal Dialysis Catheter Left in Place after Kidney Transplantation

et al. 2017

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No clear consensus has been reached regarding the optimal time to remove the peritoneal dialysis catheter (PDC) after kidney transplantation (KT). This retrospective observational study, conducted in a single peritoneal dialysis (PD) unit including all PD patients who received a KT between 1995 - 2015, was undertaken to evaluate the clinical outcomes and potential complications associated with a PDC left in place after KT. Of the 132 PD patients who received a KT, 20 were excluded from the study. Of the remaining, 112 (85%) patients with functioning KT were discharged with their PDC left in place and had it removed in a mean interval of 5 ± 3 months after KT, after achieving optimal graft function. During this follow-up period, 7 patients (6%) developed exit-site infection and there were 2 cases (2%) of peritonitis; all of them were successfully treated. Delayed PDC removal after KT is associated with low complication rates, although regular examination is needed so that mild infections can be detected early and therapy promptly instituted.

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“…In a retrospective observation study of patients with DGF requiring HD or PD, Thomson et al[42] found an increased risk of wound infection/leakage (PD 5/14 vs HD 6/63, P = 0.024), shorter length of hospitalization (PD 13.7 d vs HD 18.7 d, P = 0.009) and lesser time requiring dialysis post-operatively (PD 6.5 d vs HD 11.0 d, P = 0.043) with use of PD however no differences in readmission to hospital within 6 mo, graft loss or acute rejection episodes at one year. GFR also did not differ between the PD and HD groups at one month, six months or at one year[42].…”

Section: Esrd Outcomesmentioning

confidence: 99%

“…Patients receive multiple immunosuppressive medications in post-transplant period which increases the risk of infections. Infectious complications related with PD catheter after transplantation remain a concern[42,50]. In a study by Rizzi et al[51] on 313 PD patients who underwent transplantation between 2000 to 2015, authors found that 8.9% patients had post-transplant peritonitis especially among those who had DGF requiring dialysis.…”

Section: Esrd Outcomesmentioning

confidence: 99%

Insulin receptors in the kidneys in health and disease

Singh¹,

Sharma²,

Kumari³

et al. 2019

WJN

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The population of patients with end stage renal disease (ESRD) is increasing, lengthening waiting lists for kidney transplantation. Majority of the patients are not able to receive a kidney transplant in timely manner even though it is well established that patient survival and quality of life after kidney transplantation is far better when compared to being on dialysis. A large number of patients who desire a kidney transplant ultimately end up needing some form of dialysis therapy. Most of incident ESRD patients choose hemodialysis (HD) over peritoneal dialysis (PD) as the modality of choice in the United States, even though studies have favored PD as a better choice of pre-transplant dialysis modality than HD. PD is largely underutilized in the United States due to variety of reasons. As a part of the decision making process, patients are often educated how the choice regarding modality of dialysis would fit into their life but it is not clear and not usually discussed, how it can affect eventual kidney transplantation in the future. In this article we would like to discuss ESRD demographics and outcomes, modality of dialysis and kidney transplant related events. We have summarized the data comparing PD and HD as the modality of dialysis and its impact on allograft and recipient outcomes after kidney transplantation.

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Peritoneal dialysis versus hemodialysis in patients with delayed graft function

Cited by 13 publications

References 28 publications

Hemodialysis or Peritoneal Dialysis, Which Is Better for Patients with Delayed Graft Function?

Hemodialysis or Peritoneal Dialysis, Which Is Better for Patients with Delayed Graft Function?

Outcomes of Peritoneal Dialysis Catheter Left in Place after Kidney Transplantation

Insulin receptors in the kidneys in health and disease

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