When a kidney transplant fails, home-based dialysis is an option

Jan 13, 2011

Patients returning to dialysis after kidney transplant failure present unique challenges compared with other dialysis patients: they have been exposed to very powerful immunosuppressive medications and have been on dialysis for a longer period of time than other dialysis patients. This puts them at particularly high risk for various complications and death. According to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN), despite complications, these patients can choose to undergo dialysis in the comfort of their own homes.

Patients who have had a kidney transplant are used to managing their own therapy, enjoying the ability to travel, and living a relatively flexible lifestyle and may therefore be well-suited to peritoneal (home-based) rather than hemodialysis (clinic-based), when they return to dialysis after transplant failure. Despite the many potential benefits of peritoneal dialysis over hemodialysis—including ease of performing the therapy at home, avoidance of hospital visits several times a week, and more flexibility to travel—only a very small proportion of patients returning to dialysis after transplant failure end up choosing to undergo peritoneal dialysis in both Canada and the United States.

Jeffrey Perl, MD (St. Michael's Hospital, University of Toronto, Canada) and his colleagues evaluated the impact that dialysis type (peritoneal vs. hemodialysis) has on the survival of patients returning to dialysis after transplant failure. The investigators studied 2,110 adult Canadian patients who initiated dialysis after their kidney transplant failed between January 1991 and December 2005. The researchers evaluated the impact of initial dialysis type on early (2-year), late (after 2 years), and overall deaths.

Hemodialysis and peritoneal died at similar rates in all analyses (early, late, and overall). "It is important to empower patients who have kidney transplant failure to realize that despite the severe disappointment of returning to dialysis, they still have many options for dialysis therapy, which include opportunities for home-based therapies," said Dr. Perl. "I hope this research helps guide patients and the health care professionals treating them to make informed decisions regarding dialysis modality decisions, namely that peritoneal dialysis is as effective a therapy as hemodialysis in patients returning to dialysis after failure."

Explore further: Ebola: timeline of a ruthless killer

More information: The article, entitled "Impact of Dialysis Modality on Survival after Kidney Transplant Failure," will appear online on January 13, 2011, doi:10.2215/CJN.06640810

add to favorites email to friend print save as pdf

Related Stories

New peritoneal dialysis diagnostic discovered

Oct 17, 2007

Thanks to a discovery by scientists at Robarts Research Institute and The University of Western Ontario, patients undergoing peritoneal dialysis may soon be able to worry less about the risks of infection and lessen their ...

Recommended for you

Ebola: timeline of a ruthless killer

8 hours ago

Here are key dates in the current Ebola epidemic, the worst ever outbreak of the haemorrhagic fever which first surfaced in 1976 in the Democratic Republic of Congo (DRC).

Ebola reveals shortcomings of African solidarity

Jan 31, 2015

As Africa's leaders meet in Ethiopia to discuss the Ebola crisis, expectations of firm action will be tempered by criticism over the continent's poor record in the early stages of the epidemic.

Second bird flu case confirmed in Canada

Jan 30, 2015

The husband of a Canadian who was diagnosed earlier this week with bird flu after returning from a trip to China has also tested positive for the virus, health officials said Friday.

What exactly is coronavirus?

Jan 30, 2015

The conflicts in Syria and Iraq are straining public health systems and public health efforts meant to prevent and detect the spread of infectious diseases. This is generating a "perfect storm" of conditions for outbreaks. Among the infections raising concern is Middle East Respiratory Syndrome, caused by a type of coronavirus, which emerged in 2012. ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.