Summary of available studies on the outcome of peritoneal dialysis after failed kidney allograft^b'*'.

Summary of available studies on the outcome of peritoneal dialysis after failed kidney allograftb'*'.</p

Peritoneal transport characteristics of the study population.

Comparison between the failed transplant and control groups: (A) dialysate-to-plasma ratios of creatinine at 4-hour (D/P4); and (B) mass transfer area coefficient (MTAC) of creatinine; and, within the failed transplant group, between patients who did and did not have peritoneal dialysis (PD) before transplant: (C) D/P4; and (D) MTAC creatinine. Data were compared by student’s t test.</p

STROBE statement—Checklist of items that should be included in reports of observational studies.

STROBE statement—Checklist of items that should be included in reports of observational studies.</p

Baseline biochemical characteristics of the study population.

Baseline biochemical characteristics of the study population.</p

Patient and technique survival of the study population.

Kaplan Meier plots for (A) patient survival; and (B) technique survival of the failed transplant and control groups, and, within the failed transplant group, Kaplan Meier plot for (C) patient survival; and (D) technique survival for patients who did and did not have peritoneal dialysis (PD) before transplant. For patient survival, censoring events include conversion to long-term hemodialysis, kidney transplantation, transfer to other center, or loss to follow up. For technique survival, patient death and transfer to hemodialysis were taken as events, a second transplantation was treated as competing event, and censoring events include transfer to other center or loss to follow up. Data were compared by the log-rank test.</p

Cause of death of the study population.

BackgroundThe result of published studies on the clinical outcome of peritoneal dialysis (PD) after kidney allograft failure is conflicting. There are also few published data on the outcome of patients who had PD before kidney transplant and then return to PD after allograft failure.MethodsWe reviewed 100 patients who were started on PD after kidney allograft failure between 2001 and 2020 (failed transplant group); 50 of them received PD before transplant. We compared the clinical outcome to 200 new PD patients matched for age, sex, and diabetic status (control group).ResultsThe patients were followed for 45.8 ± 40.5 months. the 2-year patient survival rate was 83.3% and 87.8% for the failed transplant and control groups, respectively (log rank test, p = 0.2). The corresponding 2-year technique survival rate 66.5% and 71.7% (p = 0.5). The failed transplant and control groups also had similar hospitalization rate and peritonitis rate. In the failed transplant group, there was also no difference in patient survival, technique survival, hospitalization, or peritonitis rate between those with and without PD before transplant. In the failed transplant group, patients who had PD before transplant and then returned to PD after allograft failure had substantial increase in D/P4 (0.585 ± 0.130 to 0.659 ± 0.111, paired t-test, p = 0.032) and MTAC creatinine (7.74 ± 3.68 to 9.73 ± 3.00 ml/min/1.73m2, p = 0.047) from the time before the transplant to the time after PD was resumed after failed allograft.ConclusionsThe clinical outcome of PD patients with a failed kidney allograft is similar to other PD patients. However, patients who have a history of PD before kidney transplant and then return to PD after allograft failure have increased peritoneal transport parameters.</div

Demographic and clinical characteristics of the study population.

Demographic and clinical characteristics of the study population.</p

Peritonitis-free survival of the study population.

Kaplan Meier plots for (A) failed transplant versus control groups; and (B) patients who did and did not have peritoneal dialysis (PD) before transplant. Data were compared by the log-rank test.</p

Change in peritoneal transport characteristics between the time when the patients were newly put on peritoneal dialysis (PD) before kidney transplantation and back on PD after failed transplant.

(A) dialysate-to-plasma ratios of creatinine at 4-hour (D/P4); and (B) mass transfer area coefficient (MTAC) of creatinine. Open circles denote patients without peritonitis episodes before kidney transplantation; closed red triangles denote patients with peritonitis episodes before transplantation. Data were compared by paired Student’s t test.</p

Characteristics of the failed transplant group.

BackgroundThe result of published studies on the clinical outcome of peritoneal dialysis (PD) after kidney allograft failure is conflicting. There are also few published data on the outcome of patients who had PD before kidney transplant and then return to PD after allograft failure.MethodsWe reviewed 100 patients who were started on PD after kidney allograft failure between 2001 and 2020 (failed transplant group); 50 of them received PD before transplant. We compared the clinical outcome to 200 new PD patients matched for age, sex, and diabetic status (control group).ResultsThe patients were followed for 45.8 ± 40.5 months. the 2-year patient survival rate was 83.3% and 87.8% for the failed transplant and control groups, respectively (log rank test, p = 0.2). The corresponding 2-year technique survival rate 66.5% and 71.7% (p = 0.5). The failed transplant and control groups also had similar hospitalization rate and peritonitis rate. In the failed transplant group, there was also no difference in patient survival, technique survival, hospitalization, or peritonitis rate between those with and without PD before transplant. In the failed transplant group, patients who had PD before transplant and then returned to PD after allograft failure had substantial increase in D/P4 (0.585 ± 0.130 to 0.659 ± 0.111, paired t-test, p = 0.032) and MTAC creatinine (7.74 ± 3.68 to 9.73 ± 3.00 ml/min/1.73m2, p = 0.047) from the time before the transplant to the time after PD was resumed after failed allograft.ConclusionsThe clinical outcome of PD patients with a failed kidney allograft is similar to other PD patients. However, patients who have a history of PD before kidney transplant and then return to PD after allograft failure have increased peritoneal transport parameters.</div