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Related Experiment Videos

Peritoneal dialysis after a failed transplant.

Biju John1, Lily Mushahar, Simon J Davies

  • 1Department of Nephrology, University Hospital of North Staffordshire, Stoke-on-Trent and Institute for Science and Technology in Medicine, School of Medicine, Keele University, Keele, UK.

Contributions to Nephrology
|May 25, 2006
PubMed
Summary

Patients with failed kidney transplants can successfully transition to peritoneal dialysis (PD). PD offers comparable survival and technique success rates to starting dialysis for the first time, with similar peritonitis risks.

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy

Background:

  • Kidney transplant failure is a growing reason for initiating dialysis.
  • Patients require thorough physical and psychological preparation for dialysis, which is not always provided even for those known to healthcare professionals.
  • Many patients might prefer peritoneal dialysis (PD) for lifestyle reasons if adequately informed.

Purpose of the Study:

  • To evaluate the outcomes of patients starting peritoneal dialysis (PD) after kidney transplant failure.
  • To compare PD outcomes in this group with those new to dialysis, considering various risk factors.
  • To assess the impact of rapid residual renal function loss on PD patient outcomes.

Main Methods:

  • Comparative analysis of survival and technique survival rates.
  • Inclusion of risk factors such as age, comorbidity, race, gender, and membrane function in the analysis.

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  • Assessment of peritonitis risk.
  • Monitoring of residual renal function changes.

    • Main Results:

    • Patients starting PD after transplant failure show overall and technique survival comparable to new dialysis patients.
    • This holds true even when accounting for age, comorbidity, race, gender, and membrane function.
    • Peritonitis risk is not elevated in this patient group.
    • While residual renal function declines faster, it does not negatively impact outcomes.

    Conclusions:

    • Peritoneal dialysis is a viable and effective option for patients with failed kidney transplants.
    • Adequate preparation and information are crucial for these patients.
    • Further research is needed on the role of immunosuppressive drug modulation in PD patients post-transplant failure.