Pretransplant dialysis modality and kidney transplant outcome: the south african experience

Authors:Aminu Muhammad Sakajiki, Saraladevi Naicker
Int J Biol Med Res. 2020; 11(1): 6950-6952  |  PDF File

Abstract

Background Comparison of outcome of kidney allograft function between those that were treated with HD and those treated with PD while in the waitlist have been debated over time. We compared graft function, cardiovascular status and biopsy proven rejection between these two groups of kidney transplant recipients in a South African Transplant Centre. Methodology Recipients of first kidney transplant at the Charlotte Maxeke Johannesburg Academic Hospital were recruited for this study. Their records were reviewed and information collated included; age, gender, type of dialysis before transplant, duration on dialysis before transplant, duration after transplant, graft function measured using Modification of Diet in Renal Disease formula (MDRD) and presence of biopsy proven rejection. Echocardiography for assessment of cardiac function was done as well as serum cholesterol and haemoglobin. Results One hundred KTRs were recruited. There were 63 males and 37 females with M: F ratio of 1.7:1. There were 44 males and 20 females on haemodialysis while 19 males and 17 females were on peritoneal dialysis at the time of the transplant. Recipients treated withHD waited longer to be transplanted, p=0.03 while systolic blood pressure was lower in those treated with PD, p=0.012.Graft function, biopsy proven rejection, haemoglobin, serum cholesterol and cardiac function were similar among the two groups. Conclusion Shorter duration on the waitlist and lower systolic blood pressure post-transplant were the clear superiority of PD over HD in our study.