Effect of pre-transplant dialysis modality on outcomes in the first two years after kidney transplantation

Kidney transplantation (KT) is the treatment of choice for patients with end-stage renal disease (ESRD), off ering superior survival and quality of life compared with dialysis. Several observational studies have investigated the infl uence of hemodialysis (HD) and peritoneal dialysis (PD) on post-transplant outcomes. Objective: to assess the effect of dialysis modality prior to KT on outcomes during the fi rst two years after transplantation. Materials and methods . The study included 95 KT recipients, divided into two groups: (1) patients previously treated with PD (n = 45) and (2) patients previously treated with HD (n = 50). The groups were comparable in age, dialysis duration, and immunosuppressive therapy regimens. The mean follow-up period was 19.4 ± 6.4 months. Results . Delayed graft function (DGF) occurred less frequently in the PD group (17.8%) compared with the HD group (34%), although the diff erence did not reach statistical signifi cance (p = 0.08). Patients in the HD group required signifi cantly more rehospitalizations, with a median of 2.24 [1–3] compared to 1.9 [0–2.5] in the PD group (p = 0.01). Infectious complications were also more common among HD patients (62% vs 42%, p = 0.005). In particular, bacterial infections occurred signifi cantly more often in the HD group (63% vs 43%, p = 0.0001), whereas viral and fungal infections were detected at similar frequencies in both groups (p > 0.2). The incidence of graft rejection was comparable between groups. Two-year graft survival (91% in PD vs 94% in HD, p = 0.8) and patient survival (94% in PD vs 96% in HD, p = 0.9) did not diff er signifi cantly. Likewise, serum creatinine and daily proteinuria at the end of follow-up showed no statistically signifi cant diff erences (p = 0.7 and p = 0.3, respectively). Conclusion . In this study, patients who received PD prior to transplantation showed more favorable post-transplant outcomes, including a signifi cantly lower frequency of rehospitalizations and infectious complications, as well as a trend toward reduced DGF. However, two-year graft and patient survival were similar between the PD and HD groups.