Pretransplant dialysis modality and long-term outcomes in kidney transplantation recipients: A propensity score matching analysis
Jin Hyuk Paek1, Ohyun Kwon1, Yaerim Kim1, Woo Yeong Park1, Kyubok Jin1, Young-Nam Roh2, Ui Jun Park2, Hyoung Tae Kim2, Seungyeup Han1.
1Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; 2General Surgery, Keimyung University School of Medicine, Daegu, Korea
Introduction: Kidney transplantation (KT) is the ideal therapy for patients with end stage renal disease. However, preemptive KT is not always possible, most patients undergo peritoneal dialysis (PD) or hemodialysis (HD) while awaiting KT. Previous studies analyzing the impact of pretransplant dialysis modality on patient and graft survival were conflicting and follow-up period is not sufficient. We evaluated the relationship of pretransplant dialysis modality with long-term clinical outcomes by using propensity score matching method.
Methods:We conducted a 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 preemptive KT, second or third KT and 470 recipients were analyzed. After matching, 90 recipients were included in each group.
Results: The mean follow-up duration was 92.1 ± 47.8 months. Delayed graft function (p = 0.467) and biopsy proven acute rejection within 1 year after KT (p = 0.328) were comparable between the groups. PD group had lower creatinine level at 3 year after KT than HD group (p = 0.029). 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, pretransplant dialysis modality was not an independent risk factor for the patient mortality, graft failure and death-censored graft failure.
Conclusion: Pretransplant 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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