The Influence Of Dialysis Method And Timing On Complications Of Renal Transplantation In Dialysis Patients

ObiectiveThe purpose of this study was to explore the effects of different dialysis methods and dialysis timing on the complications of renal transplantation,and to provide clinical reference for the selection of dialysis methods and timing before kidney transplantation and the prevention and treatment of complications after kidney transplantation.MethodsA retrospective analysis was made of 208 dialysis patients who underwent allograft kidney transplantation in Qilu Hospital of Shandong University from January lst,2015 to June 31st,2018.The patients were divided into peritoneal dialysis group and hemodialysis group according to different dialysis methods before operation,including advanced dialysis group[<4ml/(min.l.73 m2)],intermediate dialysis group[4-7ml/(min.1.73 m2)]and early dialysis group[>7ml/(min.1.73 m2)].The clinical data of initial dialysis method,the timing of dialysis,glomerular filtration rate at the beginning of dialysis,serum creatinine before transplantation,glomerular filtration rate before transplantation,infection and chronic renal allograft failure were recorded.The influence of dialysis method and timing on the outcome of renal transplantation in dialysis patients were compared.The collected data were included in SPSS 24.0 for statistical analysis,with P<0,05 as the statistical significance.Results1.This study included 208 patients,170 males(81.73%)and 38 females(18.27%)with an average age of 49.74 years and an average dialysis time of 10.50 months.2.According to the way of dialysis,there were 34 cases(16.35%)in peritoneal dialysis group and 173 cases(83.65%)in hemodialysis group.There was no significant difference in baseline data between the two groups(P>0.05).The levels of serum triglyceride and albumin in peritoneal dialysis group were higher than those in hemodialysis group(P<0.05).There were no significant differences in level of cholesterol,low density lipoprotein cholesterol,hemoglobin,ejection fraction,creatinine before dialysis and creatinine before transplantation(P>0.05).The incidence of infection in peritoneal dialysis group was higher than that in hemodialysis group.There was no significant difference in chronic renal allograft failure between the two groups(P>0.05).3.According to the timing of dialysis before renal transplantation,51 cases(24.52%)in advanced dialysis group,59 cases(28.37%)in intermediate dialysis group and 98 cases(47.11%)in early dialysis group.There was no significant difference in the incidence of chronic renal allograft failure and infection among the three groups(P>0.05).There was no significant difference in the incidence of chronic renal allograft dysfunction between subgroups.The incidence of infection in the advanced hemodialysis group was lower than that in the non-advanced hemodialysis group(P<0.05).There was no significant difference between the advanced peritoneal dialysis group and the non-advanced group(P>0.05).Conclusions1.Different dialysis methods before transplantation have no effect on the incidence of chronic renal allograft failure,but the incidence of infection after hemodialysis kidney transplantation is lower,which can be used as the preferred dialysis method for renal transplantation patients.2.There was no significant correlation between dialysis timing and long-term complications after renal transplantation.Early dialysis may increase the incidence of infection.