Kidney transplant patients live longer than those in intensive home hemodialysis

May 22, 2014
This is Co-Director of the Kidney Transplant Program, Toronto General Hospital, University Health Network. Credit: Anthony Tuccitto

A first-ever study from a large Canadian centre found that kidney transplant recipients lived longer and had better treatment success than patients on intensive home hemodialysis, but also had an increased risk of being hospitalized within the first year.

These findings were reported in a study entitled, "Survival and hospitalization for intensive home hemodialysis and kidney transplantation", by lead author Dr. Karthik Tennankore, nephrologist at Dalhousie University, and Drs. Chris Chan and Joseph Kim, nephrologists at Toronto General Hospital, University Health Network. The study was published online on May 22, 2014 in the Journal of the American Society of Nephrology (JASN).

The research reaffirms the need to encourage patients receiving intensive home hemodialysis to pursue kidney transplantation as a definitive treatment option for end-stage kidney disease. However, the study also found that the outcomes for these specific patients were generally positive, especially when compared to patients on in-centre hemodialysis (intensive home hemodialysis patient survival was 94% and 80% at one and five years).

"For patients with end-stage kidney disease, a is still the best treatment option," says Dr. Chris Chan, Deputy Director, Division of Nephrology, University Health Network, R. Fraser Elliott Chair in Home Dialysis and Associate Professor of Medicine, University of Toronto. "But not everyone is a candidate for a transplant and we are facing a shortage of organs for these patients. We must continue to study and develop new and better ways to bridge the gap, and that includes developing better dialysis treatments." Dialysis will continue to be an important treatment option for many patients, points out Dr. Karthik Tennankore, Division of Nephrology, Dalhousie University. "This study also tells us that patients who are receiving this type of dialysis still have very good health outcomes."

Due to long waiting times for kidney transplants – up to 10 years in the Greater Toronto Area (GTA) depending on blood type and other factors - the authors note that it is important to identify "bridging therapies" for patients with end-stage kidney disease.

Kidney transplantation remains the gold standard for kidney failure treatment, but intensive home hemodialysis (16 hours or more of treatments a week) is emerging as a with many clinical advantages, such as minimal adverse reactions, low rates of hospital admission and hospital stay, and superior outcomes to conventional in-centre dialysis treatment, which is usually given three times a week.

While studies have previously shown that in-centre dialysis does not have the same benefits as a kidney transplant, it is not clear how intensive home hemodialysis compares with .

This observational study looked at 1,690 patients, comparing 173 patients on intensive home hemodialysis to 1,517 kidney transplant recipients from both deceased and living donors who received their transplants at Toronto General Hospital, University Health Network from 2000 to 2011.

The study found that kidney transplant patients had a 55% to 61% reduced risk of treatment failure or death during the study period when compared to the home hemodialysis patients. The risk of being admitted to the hospital and spending a longer time in the hospital was higher for some kidney up to a year after transplantation, likely due to surgical complications, infections, acute rejection, and other related issues. However, the risk of hospitalizations was lower for in the long-term when compared to home hemodialysis , with the latter likely related to the development of late-dialysis complications.

At the time of the study, Dr. Karthik Tennankore was the Baxter - University Health Network Home Dialysis Fellow.

Explore further: Many patients who could benefit from home dialysis are receiving care in dialysis centers

More information: The article, entitled "Survival and Hospitalization for Intensive Home Hemodialysis Compared with Kidney Transplantation," will appear online at on May 22, 2014.

The editorial, entitled "Mind the Gap," will appear online at on May 22, 2014.

Related Stories

Many patients who could benefit from home dialysis are receiving care in dialysis centers

April 24, 2014
Many kidney failure patients in Australia who could benefit from undergoing dialysis at home are being treated in hospitals and dialysis units, according to a study appearing in an upcoming issue of the Clinical Journal of ...

Intensive kidney dialysis indicates better survival rates than conventional dialysis

April 25, 2012
Patients suffering with end-stage renal disease could increase their survival chances by undergoing intensive dialysis at home rather than the conventional dialysis in clinics. A new study by Lawson Health Research Institute ...

Walking may have profound benefits for patients with kidney disease

May 15, 2014
For individuals with kidney disease, walking may help prolong life and reduce the risk of needing dialysis or a kidney transplant. That's the conclusion of a study appearing in an upcoming issue of the Clinical Journal of ...

Intensive dialysis in pregnant women with kidney failure benefits mother and baby

February 13, 2014
Intensive dialysis treatments in pregnant women with kidney failure lead to a higher proportion of live births than standard dialysis care, according to a study appearing in an upcoming issue of the Journal of the American ...

Recommended for you

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

MRSA emerged years before methicillin was even discovered

July 19, 2017
Methicillin resistant Staphylococcus aureus (MRSA) emerged long before the introduction of the antibiotic methicillin into clinical practice, according to a study published in the open access journal Genome Biology. It was ...

New test distinguishes Zika from similar viral infections

July 18, 2017
A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology ...

'Superbugs' study reveals complex picture of E. coli bloodstream infections

July 18, 2017
The first large-scale genetic study of Escherichia coli (E. coli) cultured from patients with bloodstream infections in England showed that drug resistant 'superbugs' are not always out-competing other strains. Research by ...

Ebola virus can persist in monkeys that survived disease, even after symptoms disappear

July 17, 2017
Ebola virus infection can be detected in rhesus monkeys that survive the disease and no longer show symptoms, according to research published by Army scientists in today's online edition of the journal Nature Microbiology. ...

Mountain gorillas have herpes virus similar to that found in humans

July 13, 2017
Scientists from the University of California, Davis, have detected a herpes virus in wild mountain gorillas that is very similar to the Epstein-Barr virus in humans, according to a study published today in the journal Scientific ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.