Paired Analysis of Outcomes After Kidney Transplantation in Peritoneal and Hemodialysis Patients
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. To minimize donor bias, a paired kidney analysis was applied. One hundr...
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| Veröffentlicht in: | Transplantation proceedings 2018-07, Vol.50 (6), p.1646-1653 |
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| creator | Dębska-Ślizień, A. Bobkowska-Macuk, A. Bzoma, B. Moszkowska, G. Milecka, A. Zadrożny, D. Wołyniec, W. Chamienia, A. Lichodziejewska-Niemierko, M. Król, E. Śledziński, Z. Rutkowski, B. |
| description | 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.
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).
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.
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.
•A paired kidney analysis was applied to evaluate the impact of dialysis modality on posttransplantation follow-up in 133 pairs receiving grafts from the same donor.•Long-term transplantation outcome is similar in patients with either PD or HD.•Peritoneal dialysis (PD) and hemodialysis groups (HD) differ in some aspects, such as susceptibility to vascular thrombosis in PD, and to delayed graft function (DGF) and acute rejection (AR) in HD. |
| doi_str_mv | 10.1016/j.transproceed.2018.02.104 |
| format | Article |
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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).
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.
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.
•A paired kidney analysis was applied to evaluate the impact of dialysis modality on posttransplantation follow-up in 133 pairs receiving grafts from the same donor.•Long-term transplantation outcome is similar in patients with either PD or HD.•Peritoneal dialysis (PD) and hemodialysis groups (HD) differ in some aspects, such as susceptibility to vascular thrombosis in PD, and to delayed graft function (DGF) and acute rejection (AR) in HD.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2018.02.104</identifier><identifier>PMID: 29961550</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Delayed Graft Function - etiology ; Female ; Glomerular Filtration Rate ; Graft Rejection - etiology ; Graft Survival ; Humans ; Immunosuppressive Agents ; Kaplan-Meier Estimate ; Kidney Diseases - therapy ; Kidney Transplantation - adverse effects ; Kidney Transplantation - methods ; Male ; Matched-Pair Analysis ; Middle Aged ; Peritoneal Dialysis - adverse effects ; Peritoneal Dialysis - methods ; Postoperative Complications - etiology ; Renal Dialysis - adverse effects ; Renal Dialysis - methods ; Retrospective Studies ; Thrombosis - etiology ; Treatment Outcome</subject><ispartof>Transplantation proceedings, 2018-07, Vol.50 (6), p.1646-1653</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-966212ef69e88a7a309d6edb14089cafd54d0929a53aa30edd3c10da246f3cfb3</citedby><cites>FETCH-LOGICAL-c380t-966212ef69e88a7a309d6edb14089cafd54d0929a53aa30edd3c10da246f3cfb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.transproceed.2018.02.104$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29961550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dębska-Ślizień, A.</creatorcontrib><creatorcontrib>Bobkowska-Macuk, A.</creatorcontrib><creatorcontrib>Bzoma, B.</creatorcontrib><creatorcontrib>Moszkowska, G.</creatorcontrib><creatorcontrib>Milecka, A.</creatorcontrib><creatorcontrib>Zadrożny, D.</creatorcontrib><creatorcontrib>Wołyniec, W.</creatorcontrib><creatorcontrib>Chamienia, A.</creatorcontrib><creatorcontrib>Lichodziejewska-Niemierko, M.</creatorcontrib><creatorcontrib>Król, E.</creatorcontrib><creatorcontrib>Śledziński, Z.</creatorcontrib><creatorcontrib>Rutkowski, B.</creatorcontrib><title>Paired Analysis of Outcomes After Kidney Transplantation in Peritoneal and Hemodialysis Patients</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>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.
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).
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.
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.
•A paired kidney analysis was applied to evaluate the impact of dialysis modality on posttransplantation follow-up in 133 pairs receiving grafts from the same donor.•Long-term transplantation outcome is similar in patients with either PD or HD.•Peritoneal dialysis (PD) and hemodialysis groups (HD) differ in some aspects, such as susceptibility to vascular thrombosis in PD, and to delayed graft function (DGF) and acute rejection (AR) in HD.</description><subject>Adult</subject><subject>Aged</subject><subject>Delayed Graft Function - etiology</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Graft Rejection - etiology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Immunosuppressive Agents</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney Diseases - therapy</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney Transplantation - methods</subject><subject>Male</subject><subject>Matched-Pair Analysis</subject><subject>Middle Aged</subject><subject>Peritoneal Dialysis - adverse effects</subject><subject>Peritoneal Dialysis - methods</subject><subject>Postoperative Complications - etiology</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Dialysis - methods</subject><subject>Retrospective Studies</subject><subject>Thrombosis - etiology</subject><subject>Treatment Outcome</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMFuGyEURVHVqnbS_kKFsspm3AfM4JnuLCetq1qKF-6aYHgjYc1ACjiS_z44dqQsu0LonvcuHEJuGMwYMPl9P8tR-_QUg0G0Mw6snQEvWf2BTFk7FxWXXHwkU4CaVUzUzYRcpbSHcue1-EwmvOskaxqYkseNdhEtXXg9HJNLNPT04ZBNGDHRRZ8x0j_OejzS7WvnoH3W2QVPnacbjC4Hj3qg2lu6wjFYd9mzKRT6nL6QT70eEn69nNfk78_77XJVrR9-_V4u1pURLeSqk5Izjr3ssG31XAvorES7YzW0ndG9bWoLHe90I3QJ0VphGFjNa9kL0-_ENbk97y1a_h0wZTW6ZHAoD8ZwSIqDFHMO80YW9McZNTGkFLFXT9GNOh4VA3UyrPbqvWF1MqyAl6wuw98uPYfdWLK30TelBbg7A1h---wwqmSKCYO2iDZZ2eD-p-cFsjSVdA</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Dębska-Ślizień, A.</creator><creator>Bobkowska-Macuk, A.</creator><creator>Bzoma, B.</creator><creator>Moszkowska, G.</creator><creator>Milecka, A.</creator><creator>Zadrożny, D.</creator><creator>Wołyniec, W.</creator><creator>Chamienia, A.</creator><creator>Lichodziejewska-Niemierko, M.</creator><creator>Król, E.</creator><creator>Śledziński, Z.</creator><creator>Rutkowski, B.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201807</creationdate><title>Paired Analysis of Outcomes After Kidney Transplantation in Peritoneal and Hemodialysis Patients</title><author>Dębska-Ślizień, A. ; Bobkowska-Macuk, A. ; Bzoma, B. ; Moszkowska, G. ; Milecka, A. ; Zadrożny, D. ; Wołyniec, W. ; Chamienia, A. ; Lichodziejewska-Niemierko, M. ; Król, E. ; Śledziński, Z. ; Rutkowski, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-966212ef69e88a7a309d6edb14089cafd54d0929a53aa30edd3c10da246f3cfb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Delayed Graft Function - etiology</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Graft Rejection - etiology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Immunosuppressive Agents</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney Diseases - therapy</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Kidney Transplantation - methods</topic><topic>Male</topic><topic>Matched-Pair Analysis</topic><topic>Middle Aged</topic><topic>Peritoneal Dialysis - adverse effects</topic><topic>Peritoneal Dialysis - methods</topic><topic>Postoperative Complications - etiology</topic><topic>Renal Dialysis - adverse effects</topic><topic>Renal Dialysis - methods</topic><topic>Retrospective Studies</topic><topic>Thrombosis - etiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dębska-Ślizień, A.</creatorcontrib><creatorcontrib>Bobkowska-Macuk, A.</creatorcontrib><creatorcontrib>Bzoma, B.</creatorcontrib><creatorcontrib>Moszkowska, G.</creatorcontrib><creatorcontrib>Milecka, A.</creatorcontrib><creatorcontrib>Zadrożny, D.</creatorcontrib><creatorcontrib>Wołyniec, W.</creatorcontrib><creatorcontrib>Chamienia, A.</creatorcontrib><creatorcontrib>Lichodziejewska-Niemierko, M.</creatorcontrib><creatorcontrib>Król, E.</creatorcontrib><creatorcontrib>Śledziński, Z.</creatorcontrib><creatorcontrib>Rutkowski, B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dębska-Ślizień, A.</au><au>Bobkowska-Macuk, A.</au><au>Bzoma, B.</au><au>Moszkowska, G.</au><au>Milecka, A.</au><au>Zadrożny, D.</au><au>Wołyniec, W.</au><au>Chamienia, A.</au><au>Lichodziejewska-Niemierko, M.</au><au>Król, E.</au><au>Śledziński, Z.</au><au>Rutkowski, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Paired Analysis of Outcomes After Kidney Transplantation in Peritoneal and Hemodialysis Patients</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2018-07</date><risdate>2018</risdate><volume>50</volume><issue>6</issue><spage>1646</spage><epage>1653</epage><pages>1646-1653</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><abstract>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.
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).
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.
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.
•A paired kidney analysis was applied to evaluate the impact of dialysis modality on posttransplantation follow-up in 133 pairs receiving grafts from the same donor.•Long-term transplantation outcome is similar in patients with either PD or HD.•Peritoneal dialysis (PD) and hemodialysis groups (HD) differ in some aspects, such as susceptibility to vascular thrombosis in PD, and to delayed graft function (DGF) and acute rejection (AR) in HD.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29961550</pmid><doi>10.1016/j.transproceed.2018.02.104</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Transplantation proceedings, 2018-07, Vol.50 (6), p.1646-1653 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aged Delayed Graft Function - etiology Female Glomerular Filtration Rate Graft Rejection - etiology Graft Survival Humans Immunosuppressive Agents Kaplan-Meier Estimate Kidney Diseases - therapy Kidney Transplantation - adverse effects Kidney Transplantation - methods Male Matched-Pair Analysis Middle Aged Peritoneal Dialysis - adverse effects Peritoneal Dialysis - methods Postoperative Complications - etiology Renal Dialysis - adverse effects Renal Dialysis - methods Retrospective Studies Thrombosis - etiology Treatment Outcome |
| title | Paired Analysis of Outcomes After Kidney Transplantation in Peritoneal and Hemodialysis Patients |
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