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

January 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: New peritoneal dialysis diagnostic discovered

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

Related Stories

New peritoneal dialysis diagnostic discovered

October 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

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...


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.