The Application of Prolonged Intermittent Renal Replacement Therapy in Patients With Delayed Graft Function After Renal Transplantation.

Abstract

Introduction: Delayed graft function (DGF) is a common early complication after renal transplantation. We aimed to investigate the clinical efficacy and safety of prolonged intermittent renal replacement therapy (PIRRT) in the treatment of patients with DGF after renal transplantation.

Methods: Clinical information on 80 patients who underwent renal transplantation in The 924th Hospital of the PLA Joint Logistics Support Force, from August 2021 to April 2024 was collected. According to the different hemodialysis methods, they were divided into: prolonged intermittent renal replacement therapy (PIRRT) and intermittent hemodialysis group (IHD). We investigate the effects of 2 dialysis methods on DGF after renal transplantation by comparing the recovery time of transplanted kidney function, the incidence of dialysis complications, and final blood creatinine level between the 2 groups.

Results: Forty patients of PIRRT group and 40 patients of IHD group conformed to our inclusion criteria. Mean DGF time in the PIRRT group was shorter than in the HDF group(10.45 day2 VS 16.43 days, P < .05, urea clearance (Kt/V) in the PIRRT group was better than in the IHD group (1.58VS1.3, P < .05), the incidence of hemodialysis complications was also low in the PIRRT group and there was a statistical difference in total dialysis time between the 2 groups. After therapy, both groups had considerably decreased mean levels of PCT, CRP, and IL-6 (P < .05). However, the IHD group had significantly higher NGAL levels than the PIRRT group (444.39 ± 182.62∶ 274.45 ± 96.34, P < .05). There was no significant difference in KIM-1 levels between the IHD and PIRRT groups. The recovery of renal function in both groups was assessed, and there was no significant difference in serum creatinine levels before therapy (P = .682 > .05). However, there were significant changes in serum creatinine levels between the 2 groups 1 month and 3 months after therapy (P = .021 and P = .016, respectively), showing that the medication was effective in improving renal function recovery. However, there was no statistically significant difference in serum creatinine levels between the 2 groups 6 months later (P = .125), showing that the recovery of renal function in both groups approached similarity after a given amount of time.

Conclusion: PIRRT was used for hemodialysis treatment of patients with DGF after renal transplantation. It can shorten the duration of DGF, reduce renal damage during DGF, and promote the recovery of transplanted kidney function.