Peritoneal Dialysis and Renal Transplantation

Abstract

Peritoneal dialysis is commonly used in patients awaiting renal transplantation. The occurrence of delayed graft function is lower in CAPD patients than in hemodialysis patients. This could be explained by the fluid expansion observed in CAPD patients before renal transplantation. Acute allograft rejection incidence is similar in peritoneal dialysis patients and hemodialysis patients. There are controversial data regarding the rate of renovascular thrombosis after renal transplantation in peritoneal dialysis patients. The dialysis modality selected prior to transplantation may explain the rate of renovascular thrombosis in peritoneal dialysis patients. There is an increasing number of patients returning to dialysis after transplantation failure. However, peritoneal dialysis is underused in failed transplant patients. There are few data available regarding the impact of dialysis modality on the outcome of failed transplant patients. Immunosuppression and transplant nephrectomy may affect the outcome of these patients on peritoneal dialysis. The aim of this article is to review the use of peritoneal dialysis in patients awaiting renal transplantation and in failed transplant patients.

Impact of the pretransplant dialysis modality on kidney transplantation outcomes: a nationwide cohort study

“… 11 However, the incidence of acute rejection after kidney transplantation is similar in recipients with PD or with HD under modern immunosuppression. 30 Combining these adverse events during kidney transplantation, recipients with HD might be at a higher risk of developing DGF after kidney transplantation, leading to worse graft survival, while recipients with PD might have more controllable infection risks.…”

Capd-Related Peritonitis after Renal Transplantation

“…This reduction may relate to the advent of potent new immunosuppressive medications. Moreover, incidence of acute rejection episodes in PD patients is no more than that of hemodialysis patients (11). Thus, leaving the catheter in place just because of concerns of need for dialysis cannot be justified when balanced against increased risk of infection.…”

The Role of Peritoneal Dialysis in Different Phases of Kidney Transplantation

“…12,13 Furthermore, it has been postulated that pre-transplant PD patients may have higher volume going into the transplant surgery than HD patients which may offer protection against DGF. 45,46 Van Biesen et al 47 looked at this theory in a small study including 40 pre-transplant PD and 79 HD patients.…”

“…The most important among these is the likelihood of higher residual renal function in patients on PD (12,13). Furthermore, it has been postulated that patients on pretransplant PD may have higher volume going into the transplant surgery than patients on HD, which may offer protection against DGF (45,46). Van Biesen et al (47) looked at this theory in a small study including 40 patients on pretransplant PD and 79 on pretransplant HD.…”