Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Kidney360. 2022 Feb 28;3(4):779-787. doi: 10.34067/KID.0000482022. eCollection 2022 Apr 28.
The utilization of peritoneal dialysis (PD) has been increasing in the past decade owing to various government initiatives and recognition of benefits such as better preservation of residual renal function, quality of life, and lower cost. The Advancing American Kidney Health initiative aims to increase the utilization of home therapies such as PD and kidney transplantation to treat end stage kidney disease (ESKD). A natural consequence of this development is that more patients will receive PD, and many will eventually undergo kidney transplantation. Therefore, it is important to understand the effect of pretransplant PD on posttransplant outcomes such as delayed graft function (DGF), rejection, thrombosis, graft, and patient survival. Furthermore, some of these patients may develop DGF, which raises the question of the utility of PD during DGF and its risks. Although transplant is the best renal replacement therapy option, it is not everlasting, and many transplant recipients must go on dialysis after allograft failure. Can PD be a good option for these patients? This is another critical question. Furthermore, a significant proportion of nonrenal solid organ transplant recipients develop ESKD. Is PD feasible in this group? In this review, we try to address all of these questions in the light of available evidence.
在过去的十年中，由于各种政府举措的推动，以及对腹膜透析（PD）在保留残余肾功能、生活质量和降低成本等方面优势的认可，PD 的应用有所增加。“推进美国肾脏健康倡议”旨在增加 PD 和肾移植等家庭疗法的应用，以治疗终末期肾病（ESKD）。这一发展的一个自然结果是，更多的患者将接受 PD 治疗，其中许多最终将接受肾移植。因此，了解 PD 对移植后结局的影响，如延迟移植物功能（DGF）、排斥反应、血栓形成、移植物和患者生存率等，非常重要。此外，这些患者中的一些可能会发生 DGF，这就提出了在 DGF 期间 PD 的应用及其风险的问题。尽管移植是最佳的肾脏替代治疗选择，但它并非永久的，许多移植受者在移植物失功后必须接受透析治疗。对于这些患者，PD 是一个好的选择吗？这是另一个关键问题。此外，相当一部分非肾脏实体器官移植受者也会发展为 ESKD。PD 在这一人群中是否可行？在这篇综述中，我们试图根据现有证据来回答所有这些问题。
