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Abstract: FR-PO881

The Outcomes of Kidney Transplantation in Patients With Different Modalities of Dialysis Under Universal Health Coverage in Thailand

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health

Authors

  • Sangthawan, Pornpen, Division of Nephrology, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
  • Ingviya, Thammasin, Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
  • Changsirikulchai, Siribha, Division of Nephrology, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Naiyok, Nakhon Naiyok, Thailand
Background

Thai patients with end-stage kidney disease (ESKD) under the Universal Health Coverage (UC) can access not only dialysis by using peritoneal dialysis (PD) first but also hemodialysis (HD) and kidney transplantation (KT). The previous studies show that KT is the most cost-effective kidney replacement therapy (KRT). There is a controversy about the effect of pre-transplant dialysis modality on graft survival after KT. This study aimed to compare the rates of receiving KT and graft survival between patients with PD and those with HD under UC.

Methods

The data of patients who registered with the National Health Security Office (NHSO) Region 4 and received PD, HD, and KT during January 2017-December 2021 were analyzed. The rates of PD or HD patients who received KT were calculated. The characteristics of these patients were identified. The one-year and three-year graft survival were compared between patients with pre-transplantation HD and PD by using Kaplan-Meier analysis.

Results

There were 9,169 cases receiving dialysis in the five years of the study period. The number of patients with PD and HD were 5,905 (64.4%) and 3,264 (35.6%), respectively. The number of PD patients receiving KT was 131(2.2%) while the number of HD patients receiving KT was 84 (2.6%). The characteristics and graft survival compared between patients with PD and HD were shown in Table 1.

Conclusion

The rates of KT in HD patients were slightly higher than in PD patients. The one-year and three-year graft survival rates were higher than 90% in both PD and HD. The one-year graft survival in PD patients was better than in HD patients but there was no difference in three-year graft survival between these dialysis modalities. The dialysis patients should be encouraged to receive KT.