Utjecaj tipa dijalize prije transplantacije na ishod transplantacije bubrega [The effect of pretransplant dialysis modality on the outcome of renal transplantation]

Le résumé fourni par la source

Introduction: Chronic renal disease is a global disease that primarily affects the elderly population and represents a major financial expense for all healthcare systems. Chronic renal disease is treated by dialysis or kidney transplantation. The goal of the research is to discover the connection between the type of dialysis before the transplantation and the outcome of the kidney transplantation. \nTest subjects and methods: This retrospective study includes all kidney recipients or pancreas and kidney recipients in the period from 2007. to 2013. at the University Hospital Merkur, Zagreb. \nResults: The research included 280 patients (106 male and 174 female). Of the total number of transplantations, there were 229 kidney transplantations and 51 simultaneous kidney and pancreas transplantations. Before the transplantation most of the patients were on HD (207), while 63 of them were on PD. According to the Kaplan-Meier survival curve, the five year survival of all the patients is 82.9 % while the graft survival is 78.5%). Considering the type of dialysis before the transplantation, there was no statistically significant differences in the survival of the patients (p=.09), kidney survival (p=.19), and graft survival censored for death of the patient (p=.16). The incidence of all infections in the first three months after transplantation was 58.9%, and 50% of all the infections were urinary infections. Considering the type of dialysis before transplantation, there were no statistically significant differences in the incidence of infections. Even though the type of dialysis before the transplantation was one of the factors that affected the value of glomerular filtration in the univariate analysis, it was lost in the multivariate analysis, where only the ages of the recipient and the donor remained as statistically significant variables that affect the function of the kidneys 6 and 12 months after the transplantation. The average price of a kidney transplantation was HRK 85.85±41.67 thousand, and for SPKT it was HRK 111.84±89.20 thousand (p= .02). There was no statistically significant difference in the price of the transplantation considering the type of dialysis before the transplantation. Delayed graft function, death of the patient, type of transplantation, and graft survival censored for death of the patient are statistically significant variables connected to the price of the transplantation. Conclusion: The type of dialysis before transplantation does not affect the survival of the patient and the graft, the incidence of infections, the value of glomerular filtration after the transplantation, or the price of the transplantation itself. That is why PD should be promoted as the first choice method for dialysis treatment of all the patients that do not have contraindications for its use.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.