Hemodialysis Or Peritoneal Dialysis,Which Is Better For Patients With Delayed Graft Function?

AimHemodialysis(HD)or peritoneal dialysis(PD)is an important renal replacement method in patients with delayed graft function(DGF)after kidney transplantation;however,it is not clear which dialysis modality is superior.This study determined the impact of different dialysis modalities on patients with DGF.MethodsIt was a single-center,retrospective and descriptive study.We performed 673 kidney transplants from donors after cardiac death(DCD)between January 2010 and December 2016 at our center and 138(20.5%)recipients developed DGF after transplantation.We classified the recipients into two groups according to pre-transplant dialysis:DGF-HD(n=96)and DGF-PD(n=42).We analyzed the outcomes of the different dialysis modalities 30 days and 1 year post-transplantation.ResultsThere were no differences in baseline factors between patients with post-transplant HD(n=96)or PD(n=42).There were 10 patients with conversion from PD to HD during DGF.The DGF-PD patients had a higher rate of treatment failure than the DGF-HD patients(0%vs.23.8%,P<0.001),peritonitis(0%vs.7.1%,P=0.027),and longer duration of dialysis dependence(9 vs.10.5 days,p=0.003).There was no statistically significant difference between both groups with respect to acute rejection,hemorrhage,and patient and graft survival at 1 year.ConclusionIn renal transplant recipients with DGF,post-transplant PD led to increased treatment failure.PD did not result in rapid recovery of transplanted renal function,and had a high probability of peritonitis.