Clinical outcomes of incident peritoneal dialysis patients coming from kidney transplantation program: A case-control study


Autoři: Laurisson Albuquerque da Costa aff001;  Maria Cláudia Cruz Andreoli aff001;  Aluizio Barbosa Carvalho aff001;  Sérgio Antonio Draibe aff001;  José Osmar Medina Pestana aff001;  Maria Eugênia Fernandes Canziani aff001
Působiště autorů: Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil aff001
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227870

Souhrn

Introduction

Brazil ranks second in the absolute number of transplantations in the world. Despite improvements in graft survival, many patients will progress to graft loss and return to dialysis. Concerns exist regarding adverse clinical outcomes in this population when undergone peritoneal dialysis (PD).

Objective

To compare the occurrence of mortality, technique failure, and peritonitis among incident patients in PD coming from either Tx or pre-dialysis treatment.

Methodology

A retrospective study in which 47 adult patients with Tx failure (Tx group) were matched for age, gender, diabetes mellitus (DM), modality and start year of PD, with 1:1 predialysis patient (nTx group). The Fine-Gray competing risk model was used to analyze mortality and technique failure.

Results

Compared to nTx, the Tx group had a lower body mass index, serum potassium, and albumin concentrations. A higher ferritin level, transferrin saturation and the number of patients with positive serology for viral hepatitis were also observed in the Tx group. In the multivariate analysis, patients of the Tx group had 4.4-times higher risk of death (p = 0.007), with infection as the main cause. Technique failure and peritonitis were similar in both groups.

Conclusion

Previous Tx is a risk factor for mortality but not for technique failure or peritonitis in incident patients on a PD program.

Klíčová slova:

Albumins – Death rates – Diabetes mellitus – Immunosuppressives – Medical dialysis – Medical risk factors – Peritonitis – Renal transplantation


Zdroje

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