Paired Analysis of Outcomes After Kidney Transplantation in Peritoneal and Hemodialysis Patients

被引：9

作者：

Debska-Slizien, A. ^{[1
]}

Bobkowska-Macuk, A. ^{[1
]}

Bzoma, B. ^{[1
]}

Moszkowska, G. ^{[2
]}

Milecka, A. ^{[3
]}

Zadrozny, D. ^{[3
]}

Wolyniec, W. ^{[4
]}

Chamienia, A. ^{[5
,6
]}

Lichodziejewska-Niemierko, M. ^{[7
]}

Krol, E. ^{[1
]}

Sledzinski, Z. ^{[3
]}

Rutkowski, B. ^{[1
]}

机构：

[1] Med Univ Gdansk, Dept Nephrol Transplantol & Internal Med, Ul Debinki 7, PL-80211 Gdansk, Poland

[2] Med Univ Gdansk, Dept Clin Immunol & Transplantol, Gdansk, Poland

[3] Med Univ Gdansk, Dept Gen Endocrine & Transplant Surg, Gdansk, Poland

[4] Med Univ Gdansk, Dept Occupat Metab & Internal Med, Gdansk, Poland

[5] Med Univ Gdansk, Kidney Transplant Reg Waiting List, Gdansk, Poland

[6] Med Univ Gdansk, Dept Gen Nursing, Fac Med Sci, Gdansk, Poland

[7] Med Univ Gdansk, Dept Palliat Med, Gdansk, Poland

来源：

TRANSPLANTATION PROCEEDINGS | 2018年 / 50卷 / 06期

关键词：

PRETRANSPLANT DIALYSIS MODALITY; RENAL-ALLOGRAFT THROMBOSIS; DECEASED DONOR; REPLACEMENT THERAPY; RECIPIENTS; SURVIVAL; IMPACT; PREDICTION; RESIDUALS; FAILURE;

D O I：

10.1016/j.transproceed.2018.02.104

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. The impact of dialysis modality before kidney transplantation (hemodialysis or peritoneal dialysis) on outcomes is not clear. In this study we retrospectively analyzed the impact of dialysis modality on posttransplant follow-up. Methods. To minimize donor bias, a paired kidney analysis was applied. One hundred thirty-three pairs of peritoneal dialysis (PD) and hemodialysis (HD) patients were transplanted at our center between 1994 and 2016. Those who received kidneys from the same donor were included in the study. HD patients were significantly older (44 vs 48 years), but the Charlson Comorbidity Index was similar (3.12 vs 3.46) in both groups. The groups did not differ significantly with respect to immunosuppressive protocols and number of mismatches (2.96 vs 2.95). Results. One-year patient (98% vs 96%) and graft (90% vs 93%) survival was similar in the PD and HD patient groups. The Kaplan-Meier curves of the patients and graft survival did not differ significantly. Delayed graft function (DGF) and acute rejection (AR) occurred significantly more often in the HD recipients. Graft vessel thrombosis resulting in graft loss occurred in 9 PD (6.7%) and 4 HD (3%) patients (P > .05). Serum creatinine concentration and estimated glomerular filtration rate (using the Modification of Diet in Renal Disease guidelines) showed no difference at 1 month, 1 year, and at final visit. On multivariate analysis, factors significantly associated with graft loss were graft vessel thrombosis, DGF, and graft function 1 month after transplantation. On univariate analysis, age, coronary heart disease, and graft loss were associated with death. Among these factors, only coronary heart disease (model 1) and graft loss were significant predictors of death on multivariate analysis. Conclusion. The long-term outcome for renal transplantation is similar in patients with PD and HD. These groups differ in some aspects, however, such as susceptibility to vascular thrombosis in PD patients, and to DGF and AR in HD patients.

引用

页码：1646 / 1653

页数：8

共 32 条

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