title: Dialysis within 24 hours of transplant does not improve graft function.
abstract: OBJECTIVE
  Grafts from extended criteria donors, donors after cardiac death, and elderly donors have an increased risk of delayed graft function, lower graft survival, longer hospital stay, higher costs, and increased medical sequelae. A modifiable risk factor for delayed graft function may be the performance of dialysis on the same day as renal transplant. We reviewed our institutional experience to determine whether dialysis performed within 24 hours of engraftment increased the incidence or length of delayed graft function.
  
  
  METHODS
  We retrospectively reviewed our kidney transplants performed between 2008 and 2012. Preemptive transplants, transplants associated with peritoneal dialysis, potassium > 5 mmol/L, or living donors, and cases with insufficient information were excluded. Data collected included demographic, biochemical, donor, operative, and outcome variables (length of stay, length of delayed graft function, rejection, and a composite unfavorable outcome comprising cardiac and infectious events). Transplants that were associated with hemodialysis within 24 hours before transplant (study group) were compared with the remainder of the cohort (control group).
  
  
  RESULTS
  A total of 205 renal transplants were reviewed. There were 144 of 205 transplants (70.24%) in the study group, and the others comprised the control group. The rate of delayed graft function was 31% for the study group and 29% for control groups (P = .4959). Mean length of delayed graft function was 5.8 days for the study group and 6.1 days for control group (P = .7323). Delayed graft function risk factors such as donor age, terminal creatinine, and machine perfusion rate were similarly distributed across both groups.
  
  
  CONCLUSIONS
  Normokalemic patients who did or did not undergo dialysis within 24 hours before transplant had equivalent incidence and duration of delayed graft function, graft outcomes, and patient outcomes. Therefore, dialysis within 24 hours before transplant is unnecessary in the setting of normokalemia.
authors: From the Department of Surgery, Drexel University College of Medicine, Philadelphia, PA, USA.
authors: Mohammad F
authors: MF
authors: Shaikh
authors: Farah
authors: F
authors: Karipineni
authors: Afshin
authors: A
authors: Parsikia
authors: Po-Nan
authors: PN
authors: Chang
authors: Kamran
authors: K
authors: Khanmoradi
authors: Stalin
authors: S
authors: Campos
authors: Radi
authors: R
authors: Zaki
authors: Jorge
authors: J
authors: Ortiz
mesh_terms: D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D006435:Renal Dialysis / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011188:Potassium