Pre-transplant dialysis modality does not influence short-or long-term outcome in kidney transplant recipients: analysis of paired kidneys from the same deceased donor

被引:23
作者
Dipalma, Teresa [1 ]
Fernandez-Ruiz, Mario [2 ]
Praga, Manuel [1 ]
Polanco, Natalia [1 ]
Gonzalez, Esther [1 ]
Gutierrez-Solis, Elena [1 ]
Gutierrez, Eduardo [1 ]
Andres, Amado [1 ]
机构
[1] Univ Complutense, Hosp Univ 12 Octubre, Inst Invest Hosp 12 Octubre I 12, Dept Nephrol,Sch Med, Madrid, Spain
[2] Univ Complutense, Hosp Univ 12 Octubre, Inst Invest Hosp 12 Octubre I 12, Unit Infect Dis,Sch Med, Madrid, Spain
关键词
hemodialysis; kidney transplantation; outcomes; peritoneal dialysis; pre-transplant dialysis modality; AMBULATORY PERITONEAL-DIALYSIS; RENAL-ALLOGRAFT THROMBOSIS; GRAFT FUNCTION; HEMODIALYSIS-PATIENTS; RISK-FACTORS; SURVIVAL; CAPD; CYCLOSPORINE; LYMPHOCELE; REJECTION;
D O I
10.1111/ctr.12793
中图分类号
R61 [外科手术学];
学科分类号
摘要
Previous studies have reported contradictory results regarding the effect of pre-transplant dialysis modality on the outcomes after kidney transplantation (KT). To minimize the confounding effect of donor-related variables, we performed a donor-matched retrospective comparison of 160 patients that received only one modality of pre-transplant dialysis (peritoneal dialysis [PD] and hemodialysis [HD] in 80 patients each) and that subsequently underwent KT at our center between January 1990 and December 2007. Cox regression models were used to evaluate the association between pre-transplant dialysis modality and primary study outcomes (death-censored graft survival and patient survival). To control for imbalances in recipient-related baseline characteristics, we performed additional adjustments for the propensity score (PS) for receiving pre-transplant PD (versus HD). There were no significant differences according to pre-transplant dialysis modality in death-censored graft survival (PS-adjusted hazard ratio [aHR]: 0.65; 95% confidence interval [95% CI]: 0.25-1.68) or patient survival (aHR: 0.58; 95% CI: 0.13-2.68). There were no differences in 10-year graft function or in the incidence of post-transplant complications either, except for a higher risk of lymphocele in patients undergoing PD (odds ratio: 4.31; 95% CI: 1.15-16.21). In conclusion, pre-transplant dialysis modality in KT recipients does not impact short-or long-term graft outcomes or patient survival.
引用
收藏
页码:1097 / 1107
页数:11
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