vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2025-4-31-40vtio-1977Research ArticleКлиническая трансплантологияClinical TransplantologyВлияние вида диализной терапии перед трансплантацией почки на первые два года посттрансплантационного периодаEffect of pre-transplant dialysis modality on outcomes in the first two years after kidney transplantationhttps://orcid.org/0000-0001-5966-0415БердинскийВ. А.BerdinskyV. A.

Виталий Андреевич Бердинский 

Москва

Moscow

vitaly.berdinsky@yandex.ruhttps://orcid.org/0000-0002-3603-8524ИвановаЕ. С.IvanovaE. S.

Иванова Екатерина Сергеевна, врач-нефролог

123182, Москва, ул. Пехотная д. 3

Ekaterina Ivanova

Address: 3, Pekhotnaya str., Moscow, 123182

katerineiv@mail.ruhttps://orcid.org/0000-0002-0184-346XВиноградовВ. Е.VinogradovV. E.

Владимир Евгеньевич Виноградов 

Москва

Moscow

vino-gradoff@yandex.ruhttps://orcid.org/0000-0002-6086-5220ФроловаН. Ф.FrolovaN. F.

Надия Фяатовна Фролова 

Москва

Moscow

nadiya.frolova@yandex.ruhttps://orcid.org/0000-0001-8264-7374КотенкоО. Н.KotenkoO. N.

Олег Николаевич Котенко

Москва

Moscow

olkotenko@yandex.ruhttps://orcid.org/0000-0003-3353-1636АртюхинаЛ. Ю.ArtyukhinaL. Yu.

Людмила Юрьевна Артюхина

Москва

Moscow

arlyu-1404@yandex.ruhttps://orcid.org/0000-0002-5731-3310ДмитриевИ. В.DmitrievI. V.

Илья Викторович Дмитриев

Москва

Moscow

ildmi@mail.ruhttps://orcid.org/0000-0001-8016-1610ДроздовП. А.DrozdovP. A.

Павел Алексеевич Дроздов

Москва

Moscow

dc.drozdov@gmail.comГБУЗ «Городская клиническая больница № 52 Департамента здравоохранения города Москвы»РоссияMunicipal Clinical Hospital No. 52Russian FederationГБУЗ «НИИ скорой помощи имени Н.В. Склифосовского Департамента здравоохранения города Москвы»РоссияSklifosovsky Research Institute of Emergency CareRussian FederationГБУЗ «Московский многопрофильный научно-клинический центр имени С.П. Боткина Департамента здравоохранения города Москвы»РоссияBotkin HospitalRussian Federation2025100120262743140Copyright © Бердинский В.А., Иванова Е.С., Виноградов В.Е., Фролова Н.Ф., Котенко О.Н., Артюхина Л.Ю., Дмитриев И.В., Дроздов П.А., 20262026Бердинский В.А., Иванова Е.С., Виноградов В.Е., Фролова Н.Ф., Котенко О.Н., Артюхина Л.Ю., Дмитриев И.В., Дроздов П.А.Berdinsky V.A., Ivanova E.S., Vinogradov V.E., Frolova N.F., Kotenko O.N., Artyukhina L.Y., Dmitriev I.V., Drozdov P.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1977

Трансплантация почки (ТП) является предпочтительным вариантом лечения пациентов с терминальной ХПН (ТХПН), поскольку обеспечивает увеличение продолжительности и улучшение качества жизни пациентов. Многочисленные наблюдательные исследования анализировали связь гемодиализа (ГД) и перитонеального диализа (ПД) с исходами ТП.

Цель

Цель: оценка влияния вида предшествующего диализа на первые два года посттрансплантационного периода.

Материалы и методы

Материалы и методы. В исследование вошли 95 реципиентов почечного трансплантата (ПТ), которые были разделены на 2 группы: 1-я группа – 45 пациентов, получавших ПД (группа ПД); 2-я группа – 50 пациентов, получавших ГД (группа ГД). Пациенты выделенных групп не различались по возрасту, длительности диализа и режиму иммуносупрессивной терапии. Средний срок наблюдения пациентов составил 19,4 ± 6,4 мес.

Результаты

Результаты. Отсроченная функция ПТ несколько реже наблюдалась у пациентов группы ПД – 17,8%, чем у пациентов ГД – 34% (р = 0,08). Пациенты группы ГД статистически значимо чаще нуждались в повторных госпитализациях, медиана количества которых в их группе составила 2,24 [1; 3], а у пациентов ПД – 1,9 [0; 2,5] (р = 0,01). Инфекции чаще развивались у пациентов ГД, чем у пациентов ПД (62% по сравнению с 42%, р = 0,005). При этом у группы ГД значимо чаще наблюдались бактериальные инфекции: 63% по сравнению с 43% (р = 0,0001), а вирусные и грибковые инфекции определялись примерно с одинаковой частотой в группах ПД и ГД (р > 0,2). Пациенты выделенных групп не различались по частоте развития отторжения. Двухлетняя выживаемость ПТ и пациентов в группах ПД и ГД статистически значимо не различалась (91 и 94% соответственно, р = 0,8; 94 и 96% соответственно, р = 0,9), как и уровни креатинина крови и суточной протеинурии к концу наблюдения (р = 0,7 и р = 0,3 соответственно).

Заключение

Заключение. В нашем исследовании у пациентов с предшествующим лечением ПД наблюдаются несколько лучшие исходы после ТП в виде достоверного снижения частоты повторных госпитализаций и инфекционных осложнений, а также тенденции к более низкой частоте отсроченной функции ПТ при отсутствии различий в выживаемости ПТ и летальности пациентов в первые два года после ТП.

Kidney transplantation (KT) is the treatment of choice for patients with end-stage renal disease (ESRD), off ering superior survival and quality of life compared with dialysis. Several observational studies have investigated the infl uence of hemodialysis (HD) and peritoneal dialysis (PD) on post-transplant outcomes.

Objective

Objective: to assess the effect of dialysis modality prior to KT on outcomes during the fi rst two years after transplantation.

Materials and methods

Materials and methods. The study included 95 KT recipients, divided into two groups: (1) patients previously treated with PD (n = 45) and (2) patients previously treated with HD (n = 50). The groups were comparable in age, dialysis duration, and immunosuppressive therapy regimens. The mean follow-up period was 19.4 ± 6.4 months.

Results

Results. Delayed graft function (DGF) occurred less frequently in the PD group (17.8%) compared with the HD group (34%), although the diff erence did not reach statistical signifi cance (p = 0.08). Patients in the HD group required signifi cantly more rehospitalizations, with a median of 2.24 [1–3] compared to 1.9 [0–2.5] in the PD group (p = 0.01). Infectious complications were also more common among HD patients (62% vs 42%, p = 0.005). In particular, bacterial infections occurred signifi cantly more often in the HD group (63% vs 43%, p = 0.0001), whereas viral and fungal infections were detected at similar frequencies in both groups (p > 0.2). The incidence of graft rejection was comparable between groups. Two-year graft survival (91% in PD vs 94% in HD, p = 0.8) and patient survival (94% in PD vs 96% in HD, p = 0.9) did not diff er signifi cantly. Likewise, serum creatinine and daily proteinuria at the end of follow-up showed no statistically signifi cant diff erences (p = 0.7 and p = 0.3, respectively).

Conclusion

Conclusion. In this study, patients who received PD prior to transplantation showed more favorable post-transplant outcomes, including a signifi cantly lower frequency of rehospitalizations and infectious complications, as well as a trend toward reduced DGF. However, two-year graft and patient survival were similar between the PD and HD groups.

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The authors declare that there are no conflicts of interest present.