HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Perl, J. Articles by Jassal, S. V. PubMed PubMed Citation Articles by Perl, J. Articles by Jassal, S. V.

PERITONEAL DIALYSIS AFTER NONRENAL SOLID ORGAN TRANSPLANTATION: CLINICAL OUTCOMES AND PRACTICAL CONSIDERATIONS

Division of Nephrology, University Health Network, Toronto, Ontario, Canada

Correspondence to: S.V. Jassal, 8NU-857, 200 Elizabeth St., Toronto, Ontario, M5G 2C4 Canada. vanita.jassal{at}uhn.on.ca

ABSTRACT

The incidence of end-stage renal disease following nonrenal solid organ transplantation (NRSOT) is increasing and is associated with a poor prognosis. The etiology of end-stage renal disease is multifactorial, with calcineurin inhibitor (CNI) nephrotoxicity being primarily responsible. The impact of dialysis modality on the survival of these patients remains unclear. Peritoneal dialysis appears to be a feasible and safe option for renal replacement therapy in NRSOT patients. Concerns that NRSOT patients are at a higher risk of infectious and noninfectious complications necessitate practical considerations when prescribing and planning for peritoneal dialysis in these patients. While nephrotoxicity is a well-recognized complication of long-term CNI use, "peritoneotoxic" effects with significant alterations in peritoneal membrane structure and function have recently been described. Further study including the role of CNI-free immunotherapy protocols to optimize the outcomes of NRSOT recipients is needed.

KEY WORDS: Survival; hemodialysis; nonrenal solid organ transplantation; calcineurin inhibitor.

Received 2 September 2008; accepted 13 January 2009.

Copyright © 2010 by Multimed Inc.