Timing of the Last Hemodialysis Session and Early Postoperative Outcomes After Kidney Transplantation

In patients with kidney failure on maintenance hemodialysis (HD), mortality is highest at the end of the long interdialytic interval, very likely from fluid overload, electrolyte imbalances, and cardiovascular stress1. A prolonged interval between the last HD session and surgery may increase perioperative risk from fluid or electrolyte derangements, whereas a very short one could heighten bleeding risk. In non-transplant surgery, observational data have linked preoperative HD timing to postoperative mortality2, but the impact of HD timing on early outcomes after kidney transplantation (KT) remains insufficiently characterized.