A comparison of transplant outcomes in peritoneal and hemodialysis patients – a paired kidney analysis

Background: Studies examining the effect of pre-transplant dialysis modality on graft and patient survival have given confl icting results. Therefore, we studied the effects of pre-transplant dialysis modality on the transplantation outcome. To minimize the donor variability and bias, a paired kidney analysis was used.
Material/Methods: From December 1994 to December 2005, 69 peritoneal dialysis (PD) (31 m, 48 f) patients received transplantation. PD constituted 12% of all kidney transplantations performed in our centre at that time. 50/69 PD patients (27 m, 23 f) aged from 14 to 64 (mean 39.9±12.4) years had their haemodialysis (HD) pair (34 m, 16 f) aged from 16 to 69 (mean 42.6±11.5) years.
Results: Studied groups (PD vs. HD) differed significantly with respect to duration of RRT before transplantation (19.7±20.4 vs. 35.5±50.7; p<0.05) months. The groups (PD vs. HD) did not differ significantly with respect to: number of mismatches, type of immunosuppressive protocol, one year patient survival (96% vs. 100%), and one-year graft survival (86% vs. 86%). PD vs. HD had lower incidence of delayed graft function (18% vs. 46%; p< 0.05) and acute rejection (22% vs. 30%), graft thrombosis was more commonly listed as a cause of graft failure in PD group, also all types of infections occurred more
frequently in PD patients (44% vs. 32%). Graft function estimated one year  after transplantation applying creatinine concentration was similar in PD vs. HD group (1.57 mg/dl vs. 1.61 mg/dl). Conclusions. The outcome of RT is similar in patients coming from either PD or HD. Delayed graft function was less common in PD patients but this potential benefit appears to be counter-balanced by other factors with are associated with the graft loss

Keywords: Kidney Transplantation