title: Pretransplant peritoneal dialysis relative to hemodialysis improves long-term survival of kidney transplant patients: a single-center observational study.
abstract: BACKGROUND
  Kidney transplantation is the best option for the treatment of end-stage renal disease in terms of survival and quality of life. These results can be influenced by the pretransplant dialysis modality. The aim of this study was to evaluate whether the pretransplantation dialysis modality influences patient and allograft survival beyond 10 years and examine the potential risk factors associated with the outcomes.
  
  
  METHODS
  We conducted an observational, retrospective, single-center clinical study that included 236 patients [118 undergoing peritoneal dialysis (PD) and 118 undergoing hemodialysis (HD)] who proceeded to transplantation during the period December 1990-2002. Donor and recipient data were collected from our hospital's clinical registries. The follow-up period extended to the patient's death, the loss of the allograft, or loss to follow-up. The end date of the study was set at March 2012.
  
  
  RESULTS
  In the multivariate analysis, the long-term patient survival rate was higher for the PD group than for the HD group [HR = 2.62 (1.01-6.8); p = 0.04]; however, the allograft survival rate was not significantly different between the two groups [HR = 0.68 (0.41-1.10); p = 0.12].
  
  
  CONCLUSIONS
  Pretransplantation dialysis modality is associated with long-term patient survival, with outcomes favoring peritoneal dialysis over hemodialysis. However, the pretransplant dialysis modality does not influence long-term graft loss risk.
authors.affiliation: Department of Nephrology, University Hospital La Paz, IdiPAZ, Madrid, Spain, mlopezoliva@hotmail.com.
authors.forename: María O
authors.initials: MO
authors.lastname: López-Oliva
authors.forename: Begoña
authors.initials: B
authors.lastname: Rivas
authors.forename: Elia
authors.initials: E
authors.lastname: Pérez-Fernández
authors.forename: Marta
authors.initials: M
authors.lastname: Ossorio
authors.forename: Silvia
authors.initials: S
authors.lastname: Ros
authors.forename: Carlos
authors.initials: C
authors.lastname: Chica
authors.forename: Ana
authors.initials: A
authors.lastname: Aguilar
authors.forename: María-Auxiliadora
authors.initials: MA
authors.lastname: Bajo
authors.forename: Fernando
authors.initials: F
authors.lastname: Escuin
authors.forename: Luis
authors.initials: L
authors.lastname: Hidalgo
authors.forename: Rafael
authors.initials: R
authors.lastname: Selgas
authors.forename: Carlos
authors.initials: C
authors.lastname: Jiménez
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000150:complications; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D057234:Preoperative Period; D012008:Recurrence; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D013927:Thrombosis / Q000150:complications; D013997:Time Factors