A prime determinant in selecting dialysis modality: peritoneal dialysis patient survival

Kim, Hyunwook; Ryu, Dong‐Ryeol

doi:10.23876/j.krcp.2017.36.1.22

Cited by 5 publications

(5 citation statements)

References 35 publications

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“…Peritoneal dialysis (PD) is possible through unidirectional transport from the vascular space to the peritoneal fluid via the peritoneal membrane, which consists of the capillary wall, interstitium, and mesothelium [1]. However, molecular mechanisms of peritoneal transport remain elusive, although aquaporin-1 at the endothelium of the capillary wall is known to play a role in regulating water permeability of the peritoneal membrane [2].…”

Section: Introductionmentioning

confidence: 99%

Tight junction protein expression from peritoneal dialysis effluent

Kim

Choi

et al. 2019

Renal Failure

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Background: We hypothesized that tight junction (TJ) proteins may have a role in paracellular transport of solute and water in peritoneal dialysis (PD) patients. Previous studies on TJ proteins in PD patients have used only cultured human peritoneal mesothelial cells (HPMCs). This study was undertaken to test whether TJ proteins are directly identified from PD effluent and whether their expressions are associated with functional parameters of PD.Methods: Dialysis effluents were collected from 40 patients undergoing PD, after the peritoneal equilibration test (PET). Different molecular sizes of Amicon Ultra-15 Centrifugal Filter Units were used to concentrate and purify proteins in PD effluents, and immunoblot analyses for occludin, ZO-1, and claudins were carried out to test for their existence and relationships with peritoneal clearance or results of the PET.Results: Immunoblotting from PD effluents revealed discrete bands of occludin (∼65 kDa), ZO-1 (∼215 kDa), claudin-1 (∼22 kDa), and claudin-15 (∼22 kDa) in all 40 patients. The peritoneal creatinine clearance inversely correlated with the protein expression of claudin-1 (r= −0.369, p= .019), and the dialysate-to-plasma creatinine ratio at 4 h PET correlated with occludin (r = 0.396, p= .011) and inversely correlated with claudin-15 (r= −0.393, p= .012).Conclusion: In PD patients, expression of peritoneal TJ proteins can be estimated from the dialysis effluent and may be used as novel peritoneal biomarkers.

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Section: Introductionmentioning

confidence: 99%

Tight junction protein expression from peritoneal dialysis effluent

Kim

Choi

et al. 2019

Renal Failure

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“…19 Selection bias was one explanation, indicating that PD was chosen for more patients with congestive heart failure. 32 Recent publication showed that the improved patient survival of PD accompanied less cardiovascular comorbidity burden, albeit the total number of PD is decreased in later period. 33 In the present study, we focused on the changing pattern of mortality hazard and HR even in the previously noted worse prognosis populations.…”

Section: Discussionmentioning

confidence: 99%

Changes in mortality hazard of the Korean long-term dialysis population: The dependencies of time and modality switch

Jeong

Kim

et al. 2020

Perit Dial Int

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Background: Many studies have compared patient survival outcome between hemodialysis (HD) and peritoneal dialysis (PD); however, time-varying risks of dialysis modality have been rarely investigated. This study aimed to investigate dialysis modality switch and its association with the survival outcome in the Korean population. Methods: Data from the Korean Society of Nephrology were used. A total of 21,840 incident dialysis patients who started dialysis in or after 2000 were analyzed. For the survival analysis, both proportional and non-proportional hazard assumptions were applied. For the modality switch, time-varying covariate Cox regression was applied. Results: During the median follow-up of 8 years, PD group showed increased adjusted hazard ratio (HR) of 1.248 (95% CI 1.071–1.454, p = 0.004) for mortality. Interaction of PD status with female sex was significant with an HR of 1.080 (95% CI 1.000–1.165, p = 0.050). Dialysis modality switch was associated with increased HR of 1.094 (95% CI 1.015–1.180, p = 0.019), albeit switch from PD to HD did not show significant HR until 6 years. Interestingly, time-varying risk analysis showed a decreased HR of PD after 10 years in the non-switcher group, which was consistent in patients with high traditional risk factors (with diabetes, elderly). Conclusions: PD was associated with increased HR of mortality in the first 8 years, then it was associated with decreased HR of mortality after 10 years. Dialysis modality switch was associated with increased mortality risk, but switch from PD to HD within 6 years did not show significant hazard of mortality.

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“…However, PD is more economical than HD because it is not only cheaper 6 , but also more likely to be employed than HD 7 . PD has a beneficial effect in maintaining residual renal function 17 , which may more positively impact the survival rates of PD during the early dialysis period 18 and after kidney transplantation 9 . According to recent registry data in Korea, the mortality of PD over HD seemed to be improved 16 , as has also been seen in other countries 11–14 .…”

Section: Discussionmentioning

confidence: 99%

Comparative study of peritoneal dialysis versus hemodialysis on the clinical outcomes in Korea: a population-based approach

Lee

Son

et al. 2019

Sci Rep

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There has been paucity of data regarding the secular trend of adverse outcomes in peritoneal dialysis (PD) as compared with hemodialysis (HD) in Korea. 96,596 patients who started dialysis between 2004–2015 in Korea were identified using the National Health Insurance Service database. The adjusted hazard ratio (HR) (95% confidence interval, CI) of PD over HD for mortality was 1.31 (1.27–1.36; P < 0.001) in the period of 2004–2007 and 1.21 (1.16–1.27; P < 0.001) in the period of 2008–2011. However, the hazard of PD over HD for mortality turned out to be insignificant in the period of 2012–2015. Similar trend was noted for nonfatal cardiovascular events (CVEs). In subgroup analysis, the hazard of PD over HD for mortality was evident, regardless of the status of age, diabetes, and comorbidity burden in 2004–2011. In 2012–2015, however, the hazard of PD over HD for mortality was insignificant when follow up was censored at one year, which became significant when follow up follow up was censored at three or five year. In conclusion, the mortality of PD over HD in Korea has been significantly improved, a finding that was paralleled by the improved nonfatal CVEs.

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A prime determinant in selecting dialysis modality: peritoneal dialysis patient survival

Cited by 5 publications

References 35 publications

Tight junction protein expression from peritoneal dialysis effluent

Tight junction protein expression from peritoneal dialysis effluent

Changes in mortality hazard of the Korean long-term dialysis population: The dependencies of time and modality switch

Comparative study of peritoneal dialysis versus hemodialysis on the clinical outcomes in Korea: a population-based approach

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