Pretransplant Dialysis Modality and Long-Term Outcomes in Kidney Transplantation

For patients with end-stage kidney disease (ESKD), kidney transplantation is the optimal therapy. However, preemptive kidney transplantation is not always possible; patients with ESKD are treated with hemodialysis or peritoneal dialysis while on the transplant waiting list. Data from previous studies of the impact of predialysis modality on patient and graft survival following transplantation were conflicting and the studies lacked sufficient follow-up.

Jin Hyuk Paek, MD, and colleagues at the Keimyung University School of Medicine, Daegu, South Korea, conducted a cohort study designed to examine the relationship of pretransplant dialysis modality with long-term clinical outcomes. The study utilized propensity score matching. Results were reported during a virtual session at the 28th International Congress of the Transplantation Society in a presentation titled Pretransplant Dialysis Modality and Long-Term Outcomes in Kidney Transplantation Recipients: A Propensity Score Matching Analysis.

The study cohort included 590 patients who underwent kidney transplantation at the medical center from 2003 to 2016. Preemptive and second or third kidney transplantations were excluded, resulting in an analysis cohort of 470 transplant recipients. Following matching, there were 90 recipients in each of the dialysis modality groups.

Mean duration of follow-up was 92.1 months. The rates of delayed graft function and biopsy-proven acute rejection in the first year following transplantation were similar in the two groups. At year 3, the peritoneal dialysis group had lower creatinine level compared with the hemodialysis group (P=.029), The two groups were similar in rates of 10-year patient survival and 10-year death-censored graft survival. In Cox proportional hazard model analysis, pretransplant modality was not an independent risk factor for patient mortality, graft failure, or death-censored graft failure.

“Pretransplant dialysis modality of peritoneal dialysis or hemodialysis did not influence long-term patient and graft survival after kidney transplantation. Moreover, short-term complications were similar between the two groups,” the researchers said.

Source: Paek JH, Kwon O, Kim Y, Park WY, et al. Pretransplant dialysis modality and long-term outcomes in kidney transplantation recipients: A propensity score matching analysis. Abstract of a presentation at the virtual 28th International Congress of the Transplantation Society (Abstract P-11.194), September 13-16, 2020.