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

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Název: Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies.
Autoři: Meng, Xiaohua, Wu, Weifei, Xu, Shuang, Cheng, Zhiqun
Zdroj: Renal Failure; Dec 2021, Vol. 43 Issue 1, p698-708, 11p, 1 Diagram, 4 Charts, 6 Graphs
Témata: KIDNEY transplantation, PERITONEAL dialysis, HEMODIALYSIS patients, SCIENTIFIC observation, TREATMENT effectiveness
Abstrakt: 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. 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). 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. 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. [ABSTRACT FROM AUTHOR]
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Databáze: Complementary Index
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Abstrakt: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. 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). 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; I<sup>2</sup>=52%; p = 0.48], number of patients with peritonitis [RR, 1.13; 95% CI, 0.97–1.32; I<sup>2</sup>=5%; p = 0.11] and mortality [RR, 1.00; 95% CI, 0.67–1.50; I<sup>2</sup>=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; I<sup>2</sup>=79%; p = 0.22], peritonitis [HR, 1.04; 95% CI, 0.72–1.50; I<sup>2</sup>=76%; p = 0.85] and mortality [HR, 1.24; 95% CI, 0.77–2.00; I<sup>2</sup>=66%; p = 0.38] between the study groups. 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. [ABSTRACT FROM AUTHOR]
ISSN:0886022X
DOI:10.1080/0886022X.2021.1914659