{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:47:46Z","timestamp":1790412466518,"version":"4.1.0"},"reference-count":53,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n The benefits and disadvantages of different pretransplant dialysis modalities and their posttransplant outcomes remain unclear in contemporary kidney transplant care.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To summarize the available evidence of the association of different pretransplant dialysis modalities, including hemodialysis and peritoneal dialysis (PD), with posttransplant outcomes.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n MEDLINE, Embase, PubMed, Cochrane Library, Scopus, CINAHL, and gray literature were searched from inception to March 18, 2022 (updated to April 1, 2022), for relevant studies and with no language restrictions.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Randomized clinical trials and nonrandomized observational (case-control and cohort) studies that investigated the association between pretransplant dialysis modality and posttransplant outcomes regardless of age or donor sources (living or deceased) were abstracted independently by 2 reviewers.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Following Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology reporting guidelines, 2 reviewers independently extracted relevant information using a standardized approach. Random-effects meta-analysis was used to estimate pooled adjusted hazard ratio (HR) or odds ratio and 95% CI.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes included all-cause mortality, overall graft failure, death-censored graft failure, and delayed graft function. Secondary outcomes included acute rejection, graft vessel thrombosis, oliguria, de novo heart failure, and new-onset diabetes after transplant.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study analyzed 26 nonrandomized studies (1 case-control and 25 cohort), including 269 715 patients (mean recipient age range, 14.5-67.0 years; reported proportions of female individuals, 29.4%-66.9%) whose outcomes associated with pretransplant hemodialysis vs pretransplant PD were compared. No significant difference, with very low certainty of evidence, was observed between pretransplant PD and all-cause mortality (13 studies; n\u2009=\u2009221 815; HR, 0.92 [95% CI, 0.84-1.01];\n P<\/jats:italic>\n \u2009=\u2009.08) as well as death-censored graft failure (5 studies; n\u2009=\u200996 439; HR, 0.98 [95% CI, 0.85-1.14];\n P<\/jats:italic>\n \u2009=\u2009.81). However, pretransplant PD was associated with a lower risk for overall graft failure (10 studies; n\u2009=\u2009209 287; HR, 0.96 [95% CI, 0.92-0.99];\n P<\/jats:italic>\n \u2009=\u2009.02; very low certainty of evidence) and delayed graft function (6 studies; n\u2009=\u200947 118; odds ratio, 0.73 [95% CI, 0.70-0.76];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001; low certainty of evidence). Secondary outcomes were inconclusive due to few studies with available data.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Results of the study suggest that pretransplant PD is a preferred dialysis modality option during the transition to kidney transplant. Future studies are warranted to address shared decision-making between health care professionals, patients, and caregivers as well as patient preferences.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.37580","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T11:03:24Z","timestamp":1666263804000},"page":"e2237580","source":"Crossref","is-referenced-by-count":33,"title":["Association Between Pretransplant Dialysis Modality and Kidney Transplant Outcomes"],"prefix":"10.1001","volume":"5","author":[{"given":"Tanun","family":"Ngamvichchukorn","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chidchanok","family":"Ruengorn","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, 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Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Hutton","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"ICES uOttawa, Ottawa, Ontario, Canada"},{"name":"School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish M.","family":"Sood","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg A.","family":"Knoll","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, 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