Association of Ethnicity and Survival in Peritoneal Dialysis: A Cohort Study of Incident Patients in Brazil

Fernandes, Natália; Hoekstra, Tiny; Beukel, Tessa O. van den; Tirapani, Luciana dos Santos; Bastos, Kleyton de Andrade; Pecoits‐Filho, Roberto; Qureshi, Abdul Rashid; Dekker, Friedo W.; Bastos, Marcus Gomes; Divino-Filho, José Carolino

doi:10.1053/j.ajkd.2013.02.364

Cited by 11 publications

(7 citation statements)

References 32 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Late referral still remains a major global concern, which can lead to death and technical failure precisely. A cohort study in Brazil reported that 3-year survival rate of patients who underwent passive PD was <60% due to basal comorbidities [48]. Contrary to a recent systematic review [19], this meta-analysis showed that shorter BIs increased the risk of mortality in PD patients.…”

Section: Discussioncontrasting

confidence: 69%

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Yin

Cao

2020

Blood Purif

View full text Add to dashboard Cite

Introduction: The best timing of peritoneal dialysis (PD) initiation after catheter implantation is still controversial. It is necessary to explore whether there exists a waiting period to minimize the risk of complications. Methods: A systematic review and meta-analysis were searched in multiple electronic databases published from inception to February 29, 2020, to identify cohort studies for evaluating the outcome and safety of unplanned-start PD (<14 days after catheter insertion). Risks of bias across studies were evaluated using Newcastle-Ottawa Quality Assessment Scale. Results: Fourteen cohort studies with a total of 2,401 patients were enrolled. We found that early-start PD was associated with higher prevalence of leaks (RR: 2.67, 95% CI, 1.55–4.61) and omental wrap (RR: 3.28, 95% CI, 1.14–9.39). Furthermore, patients of unplanned-start PD in APD group have higher risk of leaks, while those in CAPD group have a higher risk of leaks, omental wrap, and catheter malposition. In shorter break-in period (BI) group, the risk of suffering from catheter obstruction and malposition was higher for patients who started dialysis within 7 days after the surgery than for patients within 7–14 days. No significant differences were found in peritonitis (RR: 1.00; 95% CI, 0.78–1.27) and exit-site infections (RR: 1.12; 95% CI, 0.72–1.75). However, shorter BI was associated with higher risk of mortality and transition to hemodialysis (HD) while worsen early technical survival, with pooled RR of 2.14 (95% CI, 1.52–3.02), 1.42 (95% CI, 1.09–1.85) and 0.95 (95% CI, 0.92–0.99), respectively. Conclusions: Evidence suggests that patients receiving unplanned-start PD may have higher risks of mechanical complications, transition to HD, and even mortality rate while worsening early technical survival, which may not be associated with infectious complications. Rigorous studies are required to be performed.

show abstract

Section: Discussioncontrasting

confidence: 69%

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Yin

Cao

2020

Blood Purif

View full text Add to dashboard Cite

show abstract

“…The lower risk for death in racial minorities treated with PD compared with whites is consistent with what has been previously reported using data from the US Renal Data System, one single center of patients on PD in the United States, and a multicenter cohort study from Brazil. 1,6,[18][19][20][21] Minority populations treated with PD in our cohort were younger and had fewer coexisting illnesses; hence, it is possible that the differences reflect residual confounding. Several hypotheses have been put forth to explain the better health status of minorities starting dialysis, such as higher risk for death in minorities in early stages of kidney disease or renal-limited disease, particularly in blacks.…”

Section: Discussionmentioning

confidence: 96%

Racial and Ethnic Disparities in Use of and Outcomes with Home Dialysis in the United States

Mehrotra

Soohoo

Rivara

et al. 2015

JASN

View full text Add to dashboard Cite

Home dialysis, which comprises peritoneal dialysis (PD) or home hemodialysis (home HD), offers patients with ESRD greater flexibility and independence. Although ESRD disproportionately affects racial/ethnic minorities, data on disparities in use and outcomes with home dialysis are sparse. We analyzed data of patients who initiated maintenance dialysis between 2007 and 2011 and were admitted to any of 2217 dialysis facilities in 43 states operated by a single large dialysis organization, with follow-up through December 31, 2011 (n=162,050, of which 17,791 underwent PD and 2536 underwent home HD for $91 days). Every racial/ethnic minority group was significantly less likely to be treated with home dialysis than whites. Among individuals treated with in-center HD or PD, racial/ethnic minorities had a lower risk for death than whites; among individuals undergoing home HD, only blacks had a significantly lower death risk than whites. Blacks undergoing PD or home HD had a higher risk for transfer to in-center HD than their white counterparts, whereas Asians or others undergoing PD had a lower risk than whites undergoing PD. Blacks irrespective of dialysis modality, Hispanics undergoing PD or in-center HD, and Asians and other racial groups undergoing in-center HD were significantly less likely than white counterparts to receive a kidney transplant. In conclusion, there are racial/ethnic disparities in use of and outcomes with home dialysis in the United States. Disparities in kidney transplantation evident for blacks and Hispanics undergoing home dialysis are similar to those with in-center HD. Future studies should identify modifiable causes for these disparities.

show abstract

“…There is, however, a distinct lack of evidence on the mortality rates of both APD and CAPD modalities in eastern countries, which is clearly of importance in enabling healthcare providers to select the appropriate PD modality. Previous ESRD registries have documented racial differences in the crude mortality rates of patients on dialysis 11 12 , and whist the clinical outcomes of the two PD modalities have been compared in western countries, the ACM results have been somewhat inconsistent 13 14 15 16 17 18 . Three multicenter studies in western countries comparing ACM and technique failure (TF) rates between APD and CAPD methods reported similar outcomes 13 14 15 .…”

mentioning

confidence: 99%

Do Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis Have the Same Clinical Outcomes? A Ten-year Cohort Study in Taiwan

Tang

Chen

Fang

et al. 2016

Sci Rep

View full text Add to dashboard Cite

This paper reports a comprehensive comparison for mortality and technique failure rates between automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) in Taiwan. A propensity-score matched cohort study was conducted by retrieving APD and CAPD patients identified from the Taiwan National Health Insurance Research Database between 2001 and 2010. The main outcomes were the 5-year mortality and technique failure rates. Further analyses were then carried out based upon the first (2001–2004), second (2005–2007), and third (2008–2010) sub-periods. Similar baseline characteristics were identified for APD (n = 2,287) and CAPD (n = 2,287) patients. The proportion on APD therapy increased rapidly in the second sub-period. As compared to CAPD patients of this sub-period, APD patients had a significantly higher risk of mortality (HR, 1.37; 95% CI 1.09–1.72; p < 0.01) and technique failure (HR, 1.43; 95% CI, 1.10–1.86; p < 0.01), particularly in the first year after peritoneal dialysis commencement. However, APD patients had similar mortality and technique failure rates to those of CAPD patients throughout the full sample period and the first and third sub-periods. These findings do not suggest the presence of a clear advantage of CAPD over APD. Differences observed between these two modalities might be attributed to specials circumstances of sub-periods.

show abstract

Association of Ethnicity and Survival in Peritoneal Dialysis: A Cohort Study of Incident Patients in Brazil

Cited by 11 publications

References 32 publications

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Outcome and Safety of Unplanned-Start Peritoneal Dialysis according to Break-In Periods: A Systematic Review and Meta-Analysis

Racial and Ethnic Disparities in Use of and Outcomes with Home Dialysis in the United States

Do Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis Have the Same Clinical Outcomes? A Ten-year Cohort Study in Taiwan

Contact Info

Product

Resources

About