Pre-transplant dialysis modality does not influence short- or long-term outcome in kidney transplant recipients: analysis of paired kidneys from the same deceased donor
Teresa Dipalma
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Both authors contributed equally to this study.Search for more papers by this authorMario Fernández-Ruiz
Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Both authors contributed equally to this study.Search for more papers by this authorManuel Praga
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorNatalia Polanco
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorEsther González
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorElena Gutiérrez-Solis
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorEduardo Gutiérrez
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorCorresponding Author
Amado Andrés
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Correspondence
Amado Andrés, MD, Department of Nephrology, School of Medicine, Instituto de Investigación Hospital “12 de Octubre” (i+12), Hospital Universitario “12 de Octubre”, Universidad Complutense, Madrid, Spain.
Email: [email protected]
Search for more papers by this authorTeresa Dipalma
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Both authors contributed equally to this study.Search for more papers by this authorMario Fernández-Ruiz
Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Both authors contributed equally to this study.Search for more papers by this authorManuel Praga
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorNatalia Polanco
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorEsther González
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorElena Gutiérrez-Solis
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorEduardo Gutiérrez
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Search for more papers by this authorCorresponding Author
Amado Andrés
Department of Nephrology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Hospital “12 de Octubre” (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
Correspondence
Amado Andrés, MD, Department of Nephrology, School of Medicine, Instituto de Investigación Hospital “12 de Octubre” (i+12), Hospital Universitario “12 de Octubre”, Universidad Complutense, Madrid, Spain.
Email: [email protected]
Search for more papers by this authorAbstract
Previous studies have reported contradictory results regarding the effect of pre-transplant dialysis modality on the outcomes after kidney transplantation (KT). To minimize the confounding effect of donor-related variables, we performed a donor-matched retrospective comparison of 160 patients that received only one modality of pre-transplant dialysis (peritoneal dialysis [PD] and hemodialysis [HD] in 80 patients each) and that subsequently underwent KT at our center between January 1990 and December 2007. Cox regression models were used to evaluate the association between pre-transplant dialysis modality and primary study outcomes (death-censored graft survival and patient survival). To control for imbalances in recipient-related baseline characteristics, we performed additional adjustments for the propensity score (PS) for receiving pre-transplant PD (versus HD). There were no significant differences according to pre-transplant dialysis modality in death-censored graft survival (PS-adjusted hazard ratio [aHR]: 0.65; 95% confidence interval [95% CI]: 0.25–1.68) or patient survival (aHR: 0.58; 95% CI: 0.13–2.68). There were no differences in 10-year graft function or in the incidence of post-transplant complications either, except for a higher risk of lymphocele in patients undergoing PD (odds ratio: 4.31; 95% CI: 1.15–16.21). In conclusion, pre-transplant dialysis modality in KT recipients does not impact short- or long-term graft outcomes or patient survival.
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