Impact of Peritoneal Dialysis Versus Hemodialysis on Incidence of Intra‐abdominal Infection After Simultaneous Pancreas–Kidney Transplant

Abstract

In our experience, PD prior to SPK transplantation is not associated with increased incidence of intra-abdominal infection compared to HD.

Outcome of patients with hemodialysis or peritoneal dialysis undergoing simultaneous pancreas‐kidney transplantation. Comparative study

“…Several authors have reported that the use of PD compared to HD before SPKT constitutes a higher risk factor for the development of intra‐abdominal infections, showing an incidence between 23.5% and 44% in PD groups vs 7.7% and 34% in HD groups . However, other studies do not find any significant differences between the groups in the overall incidence of intra‐abdominal infections (9.6%‐28% in PD groups vs 8.8%‐30% in HD groups) . In our series, the overall rate of infections was 71%, and 55 (33%) patients showed intra‐abdominal location with no significant difference between the groups (31.6% in HD vs 35.8% in PD).…”

“…Series comparing PD and HD prior to SPKT have also shown discordant results with respect to patient and pancreas graft survival and the rate of post‐transplant intra‐abdominal infections …”

“…There is some controversy regarding the best modality of dialysis before SPKT. Thus, several authors have compared the outcomes of peritoneal dialysis (PD) and hemodialysis (HD) before SPKT, showing discordant results mainly with regard to patient and graft survivals and the development of intra‐abdominal infections …”

Peritoneal Dialysis in Diabetics: There Is Room for More

“…Adjusted analysis confirmed that pre-transplant dialysis modality does not have an impact on the subsequent development of PTDM [77]. Likewise, PD prior to simultaneous-pancreas-kidney transplantation is not associated with increased incidence of intra-abdominal infection compared to HD [78]. As described, PD may provide several advantages for diabetic patients, while risks should also be taken into account to optimize therapy (Table 1).…”

Comparison of Renal Transplantation Outcomes in Patients After Peritoneal Dialysis and Hemodialysis – A Case Control Study and Literature Review

“…However, 10 PD patients developed peritonitis [21]. Also, in a series of 100 patients undergoing simultaneous pancreas-kidney (SPK) transplantation (25 PD patients, 75 HD patients) frequency of abdominal infections, one year pancreas-graft survival rates, acute rejection episodes, kidney graft survival rates, or length of hospital stay did not differ between the two groups [25].…”