A Comparison of Transplant Outcomes in Peritoneal and Hemodialysis Patients: A Meta-Analysis.
BACKGROUND
Peritoneal dialysis (PD) and hemodialysis (HD) have been considered the 2 standard pre-transplant dialysis modalities in patients awaiting kidney transplantation. However, the impact of pretransplant dialysis on the short- and long-term post-transplant outcomes remains controversial.


METHODS
We searched PubMed, EMBASE and the Cochrane central register of controlled trials for this review. Twelve studies were identified by strict screening for the meta-analysis.


RESULTS
We found that pretransplant PD patients had a significantly lower incidence of delayed graft function than HD patients, with an OR 0.67 (95% CI 0.62-0.72, p < 0.05). In contrast, there was no significant difference in the incidence of acute rejection, OR 0.96 (95% CI 0.75-1.16). Pretransplant PD had a better 5-year patient survival rate than HD, with a hazard ratio 0.86 (95% CI 0.79-0.95, p < 0.05); however, there were no significant differences in the graft survival rate (p = 0.08).


CONCLUSIONS
We found that PD was a better choice of pretransplant dialysis modality than HD. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=446272.
Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing, China.
Maozhi
M
Tang
Tianyi
T
Li
Hong
H
Liu
D018849:Controlled Clinical Trials as Topic; D051799:Delayed Graft Function; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome