Korean J Transplant.  2020 Dec;34(Supple 1):S75. 10.4285/ATW2020.OP-1266.

Impact of dialysis modality on long-term outcomes in kidney transplantation recipients: a propensity-matched cohort study

Affiliations
  • 1Division of Nephrology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea

Abstract

Background
Kidney transplantation (KT) is the ideal therapy for patients with end stage renal disease. However, pre-emptive KT is not always possible, most patients undergo peritoneal dialysis (PD) or hemodialysis (HD) while awaiting KT. Previous studies analyzing the impact of pre-transplant dialysis modality on patient and graft survival were conflicting and follow-up period is not sufficient. We evaluated the relationship of pre-transplant dialysis modality with long-term clinical outcomes by using propensity score matching method.
Methods
We conducted a retrospective cohort study of 590 patients who underwent KT at Keimyung University Dongsan Medical Center from 2003 to 2016. Of the 590 KT recipients, we excluded pre-emptive KT, second or third KT and 470 recipients were analyzed.
Results
Among 470 KT recipients, 95 recipients (20.2%) were treated with PD before KT. After using propensity score matching method, 93 recipients were included in each group. The mean follow-up duration was 98.6±47.3 months. In the entire cohort, PD group had lower creatinine level at 3 years after KT than HD group (P=0.030). However, there was no significant differences between two groups after matching (P=0.055). Delayed graft function (P=0.662) and biopsy proven acute rejection within 1 year after KT (P=0.445) were comparable between the groups. Ten-year patient survival rates (P=0.521) and 10-year death-censored graft survival rates (P=0.407) were similar between two group. In Cox proportional hazard model, pre-transplant dialysis modality was not an independent risk factor for the patient mortality, graft failure, and death-censored graft failure.
Conclusions
Pre-transplant dialysis modality of PD or HD did not influence on the long-term patient and graft survival after KT. Moreover, short-term complications were similar between two groups.

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