Dataset Information

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naive patients: a meta-analysis of observational studies.

ABSTRACT:

Purpose

The influence of prior failed kidney transplants on outcomes of peritoneal dialysis (PD) is unclear. Thus, we conducted a systematic review and meta-analysis to compare the outcomes of patients initiating PD after a failed kidney transplant with those initiating PD without a prior history of kidney transplantation.

Methods

We searched PubMed, Embase, CENTRAL, and Google Scholar databases from inception until 25 November 2020. Our meta-analysis considered the absolute number of events of mortality, technical failures, and patients with peritonitis, and we also pooled multi-variable adjusted hazard ratios (HR).

Results

We included 12 retrospective studies. For absolute number of events, our analysis indicated no statistically significant difference in technique failure [RR, 1.14; 95% CI, 0.80-1.61; I²=52%; p = 0.48], number of patients with peritonitis [RR, 1.13; 95% CI, 0.97-1.32; I²=5%; p = 0.11] and mortality [RR, 1.00; 95% CI, 0.67-1.50; I²=63%; p = 0.99] between the study groups. The pooled analysis of adjusted HRs indicated no statistically significant difference in the risk of technique failure [HR, 1.25; 95% CI, 0.88-1.78; I²=79%; p = 0.22], peritonitis [HR, 1.04; 95% CI, 0.72-1.50; I²=76%; p = 0.85] and mortality [HR, 1.24; 95% CI, 0.77-2.00; I²=66%; p = 0.38] between the study groups.

Conclusion

Patients with kidney transplant failure initiating PD do not have an increased risk of mortality, technique failure, or peritonitis as compared to transplant-naïve patients initiating PD. Further studies are needed to evaluate the impact of prior and ongoing immunosuppression on PD outcomes.

SUBMITTER: Meng X

PROVIDER: S-EPMC8079072 | biostudies-literature |

REPOSITORIES: biostudies-literature

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