ESRD Patients Who Return To Dialysis After Kidney Transplant Die Sooner

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33% of End-Stage Renal Disease (ESRD) patients who return to dialysis after their Kidney Transplant fails die within three years. This is much higher than death rates among ESRD patients who do not receive a Kidney Transplant. The large discrepancy can be attributed to a number of causes, none less than the severe disappointment and feeling of failure from losing a transplanted kidney and having to return to the less flexible lifestyle of dialysis. This could translate into non-compliance with dialysis treatments. Other challenges for returning dialysis patients' survival include increased risk of infection caused by the effects of chronic immunosuppression exposure, high Septicemia (bacteria in blood) rates, and poor dialysis re-education.

Recommended Reading: Dialysis Treatment Option Which Is Found To Be Comparable to Cadaveric Kidney Transplant

Research finds that Peritoneal Dialysis (PD) is the best treatment option for individuals returning to dialysis in general because they prefer to manage their own therapy, enjoy the ability to travel and live a relatively flexible lifestyle after their experience of having a Kidney Transplant. Increased independence from PD treatment significantly improves returning dialysis patient's health outcomes. Also, reports suggest that the use of PD has been associated with lower rates of Septicemia which have been related in part to the use of Hemodialysis (HD). There are more extensive requirements for intensive patient training associated with PD treatment than other modalities because it requires more preparation and involves surgical tube placement.

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An increasing number of patients are returning to dialysis after their Kidney Transplants fail because of limited opportunities for repeat transplantation due to the consistently low supply of kidneys and the relatively fixed time-frame a kidney will last. In fact, kidney transplant failure accounts for 4.1% of the dialysis population and is among the top five leading individual causes of dialysis initiation in the U.S. after Diabetes, Hypertension, and Renovascular Disease.

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Individuals who must return to dialysis after a failed Kidney Transplant have a much higher death rate when compared with ESRD patients that continue dialysis uninterrupted. A Kidney Transplantation is still considered the optimal treatment option because overall Transplant Recipients have higher survival and an increased quality of life. However, most Kidney Transplants do not last a lifetime and the large majority of ESRD patients will have to return to dialysis. Research has shown that PD is better for returning dialysis patients than HD treatments because of ease of performing the therapy at home, avoidance of Dialysis Center visits several times a week, and more flexibility. Yet only a very small minority of patients returning to dialysis after transplant failure undergo peritoneal dialysis. KidneyBuzz.com encourages you to investigate these findings further and discuss this matter with your Nephrologist to determine the optimal treatment for you should you have to return to dialysis.

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References: 

"Study: Patients Returning to Dialysis after Kidney Transplant Failure Should Consider Home Modalities." Nephrology News and Issues.

"Impact of Dialysis Modality on Survival after Kidney Transplant Failure." Clinical Journal of the American Society of Nephrology.