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Long‐term clinical outcomes of nocturnal hemodialysis patients compared with conventional hemodialysis patients post‐renal transplantation
Author(s) -
Pauly Robert P.,
Asad Reem A.,
Hanley James A.,
Pierratos Andreas,
Zaltzman Jeffrey,
Chery Anne,
Chan Christopher T.
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2008.00899.x
Subject(s) - medicine , hemodialysis , transplantation , dialysis , incidence (geometry) , renal function , kidney transplantation , urology , surgery , physics , optics
Nocturnal home hemodialysis (NHD) is a novel dialysis strategy associated with multiple advantages over conventional hemodialysis (CHD). Short‐ and long‐term clinical outcomes of NHD patients after kidney transplantation are unknown. We hypothesized that the incidence of delayed graft function (DGF), patient and graft survival, and post‐transplant estimated glomerular filtration rate (eGFR) is better among CHD‐transplanted individuals than among those having received NHD. Of 231 NHD patients, 36 underwent renal transplantation between 1994 and 2006 and were matched to 68 transplanted CHD patients with a maximum follow‐up of 11.7 yr. The incidence of DGF was not different between the two groups [NHD: 15/35 (42.9%) vs. CHD: 25/68 (36.8%) p = 0.43]. In modeling eGFR pre‐transplant weight, donor age and recipient race were most predictive. Dialysis modality prior to transplantation influenced neither the level of eGFR post‐transplantation (p = 0.34), nor the rate of eGFR decline. Patient survival was comparable between NHD and CHD groups (log‐rank p = 0.91). Based on this analysis, it appeared that the incidence of DGF was similar between NHD‐ and CHD‐transplanted patients and that pre‐transplant modality did not impact on the level or rate of deterioration of post‐transplant eGFR.