Long-term clinical outcomes of peritoneal dialysis patients: 10-year experience of a single unit from Tunisia

Lasfar, Lilia Ben; Guedri, Y.; Zellama, D.; Meknassi, I.; Azzebi, A.; Mrabet, S.; Fradi, A.; Toumi, S.; Sabri, F.; Amor, S. Ben; Sahtout, W.; Achour, A.

doi:10.4103/1319-2442.256852

Cited by 6 publications

(19 citation statements)

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“…It was similar to the rates reported in the literature (20.7%-42.6%) [14,19,21]. The prevalence of mechanical complications in our series was lower compared with the different series published in the literature (21.5% vs. 31.2%-36.8%) [4,8].…”

Section: Discussionsupporting

confidence: 90%

“…In this study, the survival was inferior and mortality was higher in diabetics compared to nondiabetics. As also seen in other studies, the survival was inferior and mortality was higher in the group aged ≥65 years compared to the 2 groups (aged <40 years and ≥40 years and <65 years) in our study [8,19].…”

Section: Discussionsupporting

confidence: 87%

“…This is the first study to investigate long term outcomes and all-cause of mortality in PD patients in our centre. The mean age of our patients was similar to that reported in other studies (52.5 vs. 43.9-62.7 years) [8,18,19]. Unlike other studies, the rate of our elderly patients was higher than other studies (24.4% vs. 10.4%-15.8%) [17,18] and female participants were the majority in our patients (59.3%-63.8% vs 47.5% male) [8,18].…”

Section: Discussionsupporting

confidence: 86%

“…But the incidence of peritonitis varies greatly from unit to unit. The reported peritonitis rates were 0.16-0.44 per patient year [8,18,23]. Similarly, this rate was 0.18 (0-14.9) attacks per patient year in our study.…”

Section: Discussionsupporting

confidence: 85%

“…Peritoneal dialysis (PD) has been an alternative treatment to hemodialysis (HD) for patients with ESRD since 1976 [3,4]. PD is a homebased treatment with many advantages; preservation of residual renal function (RRF), hemodynamic stability, better quality of life and cost savings [5][6][7][8]. Survival rates with PD are better than those with HD after 3 years from initiation [5,8,9].…”

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confidence: 99%

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Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey

Tekkarismaz¹,

Torun²

2020

Turk J Med Sci

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The prevalence of end-stage renal disease (ESRD) is increasing in the world [1,2]. Peritoneal dialysis (PD) has been an alternative treatment to hemodialysis (HD) for patients with ESRD since 1976 [3,4]. PD is a homebased treatment with many advantages; preservation of residual renal function (RRF), hemodynamic stability, better quality of life and cost savings [5][6][7][8]. Survival rates with PD are better than those with HD after 3 years from initiation [5,8,9]. Despite the advantages of PD in quality of life compared with haemodialysis, the prevalence of PD decreases gradually [10,11]. In our country too, total number of PD patients is gradually decreasing over the years [12].Prevalent PD patients in our country as of the end of 2007 were 5307 patients and this number decreased to 3346 at the end of 2017, according to the Turkish Kidney Registry System Reports [12,13]. The long-term benefits of PD are still controversial [5]. Therefore, this study aimed to report a single-center experience and long-term clinical outcomes of PD over a 9-year period. Materials and methods ParticipantsThis study was approved by Baskent University Institutional Review Board (Project no: KA19/196) and supported by Başkent University Research Fund. This was a retrospective cohort study. All patients who were initiated on PD at Başkent University Adana Dr. Turgut Noyan Training and Research Hospital, in Turkey, from January 2011 to May 2019, were included. The patients who were younger than 18 years and the patients with a PD history of less than 3 months were excluded from our analysis. The follow-up of the patients was reviewed until death, renal transplantation, transferred to HD or the end of the study in May 2019. Clinical proceduresA double-cuffed Curl Tenckhoff catheter (ArgyleTM Peritoneal Dialysis Catheter Kit, Curl Catch, 2 Cuff, 62 cm) was inserted in all patients in our centre using the laparoscopy technique by general surgeons. After a break period, patients and their caregivers underwent a standard Background/aim: The aim of this study was to evaluate the clinical outcomes and identify the predictors of mortality in peritoneal dialysis patients. Materials and methods:Medical records of all incident peritoneal dialysis (PD) patients followed up between January 2011 and May 2019 were reviewed retrospectively. All patients were followed up until death, renal transplantation, transfer to haemodialysis or the end of the study.Results: A total of 242 patients were included in the study. The incidence of peritonitis was 0.18 (ranging from 0 to 14.9) episodes per patient year. Death occurred in 28% (n: 68) of cases. Age, diabetes mellitus, malignancy and refractory heart failure were independent risk factors for all-cause mortality according to multivariate analysis. The presence of comorbid disease and diabetes mellitus and patients aged > 65 years were associated with increased risk of mortality and decreased patient survival. Peritonitis history was associated with increased risk of mortality. Between peritonitis and perito...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 99%

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Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey

Tekkarismaz¹,

Torun²

2020

Turk J Med Sci

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Peritoneal dialysis–first initiative in India: a cost-effectiveness analysis

Gupta

Jyani

Ramachandran

et al. 2021

Clinical Kidney Journal

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Background The increasing burden of kidney failure in India necessitates provision of cost-effective kidney replacement therapy (KRT). We assessed the comparative cost-effectiveness of initiating KRT with peritoneal dialysis (PD) or haemodialysis (HD) in the Indian context. Methodology The cost and clinical effectiveness of starting the KRT with either PD or HD were measured in terms of life years and quality adjusted life years (QALYs) using a mathematical Markov model. Complications like peritonitis, vascular access-related complications and blood-borne infections were considered. Health system costs, out of pocket expenditure borne by patients, and indirect costs were included. Two scenarios were considered: I (Real-world scenario)—as per the current cost and utilisation patterns; II (PMNDP scenario)—use in the public sector as per Pradhan Mantri National Dialysis Program (PMNDP) guidelines. The lifetime costs and health outcomes among kidney failure patients were assessed. Results The mean QALYs lived per kidney failure person with PD and HD were estimated to be 3.3 and 1.6, respectively. From a societal perspective, PD-first policy is cost-saving as compared to HD-first policy, in both scenario I and II. If only the costs directly attributable to patient care (direct costs) are considered, PD first treatment policy is estimated to be cost-effective only if the price of PD consumables can be brought down to ₹70 per unit. CONCLUSION: PD as initial treatment is a cost-saving option for management of kidney failure in India, as compared to HD first. The government should negotiate the price of PD consumables under the PMNDP program.

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Prevalence of peritonitis and mortality in patients with ESKD treated with chronic peritoneal dialysis in Africa: a systematic review

et al. 2020

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ObjectiveThe aim of this study was to report the prevalence of peritonitis and mortality in patients with end-stage kidney disease (ESKD) treated with chronic peritoneal dialysis (PD) in Africa.DesignSystematic review.SettingAfrica.ParticipantsPatients with ESKD in Africa.InterventionsPD in its varied forms.Primary and secondary outcomesPD-related peritonitis rate (primary outcome), time-to-discontinuation of PD, mortality.Data sourcesFour databases, including PubMed, Embase, Web of Science and Africa Journal Online were systematically searched from 1 January 1980 to 31 December 2019.Eligibility criteriaStudies conducted in Africa reporting peritonitis rate and mortality in patients treated with PD.Data extraction and synthesisTwo reviewers extracted and synthesised the data using Microsoft Excel. The quality of included data was also assessed.ResultsWe included 17 studies from seven African countries representing 1894 patients treated with PD. The overall median age was 41.4 years (IQR: 38.2–44.7) with a median time on PD of 18.0 months (17.0–22.6). An overall median peritonitis rate of 0.75 (0.56–2.20) episodes per patient-year (PPY) was observed and had declined with time; peritonitis rate was higher in paediatric studies than adult studies (1.78 (1.26–2.25) vs 0.63 (0.55–1.87) episodes PPY). The overall median proportion of deaths was 21.1% (16.2–25.8). Culture negative peritonitis was common in paediatric studies and studies that reported combined outcomes of continuous ambulatory PD and automated PD. Both 1-year and 2-year technique survival were low in all studies (83.6% and 53.0%, respectively) and were responsible for a high proportion of modality switch.ConclusionsOur study identifies that there is still high but declining peritonitis rates as well as low technique and patient survival in PD studies conducted in Africa. Sustained efforts should continue to mitigate factors associated with peritonitis in patients with ESKD treated with PD in Africa.PROSPERO registration numberCRD42017072966.

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Long-term clinical outcomes of peritoneal dialysis patients: 10-year experience of a single unit from Tunisia

Cited by 6 publications

References 0 publications

Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey

Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey

Peritoneal dialysis–first initiative in India: a cost-effectiveness analysis

Prevalence of peritonitis and mortality in patients with ESKD treated with chronic peritoneal dialysis in Africa: a systematic review

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