[Peritoneal dialysis and renal or renal-pancreas transplantation]

The number of patients using continuous ambulatory peritoneal dialysis is increasing. This treatment may also be suitable for patients waiting for renal or renal-pancreas transplantation. In vitro studies of the immune status of peritoneal dialysis patients are conflicting. The most useful conclusions come from comparable series of patients transplanted after either PD or haemodialysis. All such studies report identical results for the two groups. There appears to be a consensus that transplantation should not be sooner than 2 to 6 weeks after the last peritonitis episode. The attitude to the catheter during the transplantation is similarly unanimous. It should be withdrawn 6 to 8 weeks after transplantation, except in exceptional cases. The use of a PD catheter immediately after transplantation is associated with a significant risk of peritoneal infection. Overall, continuous ambulatory peritoneal dialysis appears to be suitable for patients waiting for double renal-pancreas transplantation, assuming that the catheter is given a medial exit site.