**3. Renal transplantation in PD–patients – first experience**

autonomy with transplantation and survival, probably in favor for patients actively choosing PD as their dialysis modality [4]. Also, a small Japanese single center study in 42 patients analyzed the effect of dialysis modality on rate of kidney transplantation from living donors and transplant outcome. There were no differences between the two modalities prior to transplantation in the graft survival rate, incidence of acute rejection, and complications before and after transplantation.However, The transfer rate from PD to transplantation was signifi‐ cantly (p = 0.0036) higher (4.7%) than that of HD (1.9%). Probably reflecting better cooperation between with the patients, their family and the provision of relevant information by nephrol‐

Although in 2005 the European Best Practice Guidelines for Peritoneal Dialysis conclude, on the basis of the available data, that peritoneal dialysis is a good treatment prior to renal transplantation there are contradictory survival rates reported in the literature for patients

In 1995, data from the US Renal Data Systems from more than 170,000 patients showed, thatprevalent patients treated with PD had a 19% higher adjusted mortality risk (p< 0.001) than

In a comparable analysis obtained from the Canadian Organ Replacement Register, using data from 11,970 ESRD patientswho initiated treatment between 1990 and 1994 and were followedup for a maximum of 5 years was themortality rate ratio for CAPD/CCPD relative to hemo‐ dialysis, as estimated by Poisson regression, was 0.73. There, the increased mortality on hemodialysis compared with CAPD/CCPD was concentrated in the first 2 years of follow-up

In contrast, a study comparing two year mortality rates of patients on the waiting list for renal transplantation to a historical prospective cohort of more than 12000 PD and HD patients disclosed, that especially for patients with a body mass index (BMI) of>= 26 mortality was

Nevertheless, in a cohort of more than 3000 non-diabetic patients starting dialysis there was

Also, in the well-known, prospective Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) adjusted mortality rates between HD and PD patients were similar for the first two years. Thereafter, an increase in mortality especially in patients >= 60 years was

Comparable results were seen in a prospective multicenter cohort study in 1041 patients (767 HD, 274 PD). There, the risk of mortality was equal in both groups for the first year with an increase in the second year. In addition, 25% of PD but only 5% of the HD patients switched

and was detectable in all subgroups defined by age and diabetes status [8].

no difference in survival for patients treated either with PD or HD [10].

ogists during PD [5].

**2. Mortality on PD and HD**

194 Current Issues and Future Direction in Kidney Transplantation

either on HD or on PD[6].

those treated with HD [7].

detected [11].

increased with PD as dialysis modality [9].

their type of dialysis modality [12].

The first experience about the use of peritoneal dialysis in patients waiting for renal trans‐ plantation were published in some very early reports describing the feasibility of PD for patients awaiting renal transplantation[13-15]. Also in a small series of 15 patients the experi‐ ence with renal transplantation in PD-patients was reported. Despite the fact, that some of the PD patients had peritonitis at the time of transplantation, no differences in graft survival were shown [16].

Similar results were published in an early study with a group of 44 patients, showing compa‐ rable results for patients with PD compared to HD patients[17].

Also, a small study in 9 PD patients reported significantly greater and longer wound drainage in PD patients. However, the incidence of acute rejection episodes, delayed graft function, graft arterial thrombosis and graft function recovery was not different [18].
