Long-Term Outcome in Continuous Ambulatory Peritoneal Dialysis: A 10-Year Survey by the Italian Cooperative Peritoneal Dialysis Study Group

Lupo, Antonio; Tarchini, R; Cancarini, Giovanni; Catizone, Luigi; Cocchi, R; Vecchi, A. De; Viglino, Giusto; Salomone, Mario; Segoloni, Giuseppe; Giangrande, A

doi:10.1016/s0272-6386(12)80678-0

Cited by 88 publications

(49 citation statements)

References 3 publications

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“…Transfer to HD decreased during follow-up, from 40% during the first 3 months to 25% after 2 years, due mainly to fewer abdominal and catheter complications. A high prevalence of catheter-related problems in the earliest period of PD treatment has also been reported in other studies (7,12,13). After the first 3 months of PD treatment, reasons to switch to HD are mostly represented by infectious complications and psychosocial reasons, as also found by others (3,6,7,12,14,15).…”

Section: Discussionsupporting

confidence: 74%

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

et al. 2010

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♦♦ ♦♦ ♦ Background: Peritoneal dialysis (PD) technique failure is high compared to hemodialysis (HD). There is a lack of data on the impact of duration of PD treatment on technique survival and on whether there is a difference in risk factors with respect to early and late failure. The aim of this study was to clarify these issues by performing a timedependent analysis of PD technique and patient survival in a large cohort of incident PD patients. ♦♦ ♦♦ ♦ Methods: We analyzed 709 incident PD patients participating in the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD), who started their treatment between 1997 and 2007. We compared technique and patient survival on PD in 4 periods of follow-up: within the first 3 months, and after 3 -12 months, 12 -24 months, and 24 -36 months of treatment. Cox proportional hazards model was used to analyze survival on PD and technique failure. Risk factors were also identified by comparing patients that were transferred to HD with those that remained on PD. Incidence rates for every cause of dropout for each period of follow-up were calculated to establish their trends with respect to PD treatment duration. ♦♦ ♦♦ ♦ Results: There was a significant increase in transplantation rate after the first year of treatment. The rate of switching to HD was highest during the first 3 months and decreased afterward. One-, 2-and 3-year technique survival was 87%, 76%, and 66%, respectively. Age, diabetes, and cardiovascular disease appeared to be risk factors for death on PD or switch to HD: a 1-year increase in age was associated with a relative risk (RR) of PD failure of 1.04 [95% confidence interval (CI) 1.003 -1.06]; for diabetes, RR of stopping PD after 3 months of treatment increased from 1.8 (95% CI 1.1 -3) during the first year to 2.2 (95% CI 1.3 -4) after the second year; cardiovascular disease had a major impact in the earliest period (RR 2.5, 95% CI 1.2 -5) and had a stable influence further on (RR 2, 95% CI 1.1 -3.5).Loss of 1 mL/minute residual glomerular filtration rate (rGFR) appeared to be a significant predictor of PD failure after 3 months of treatment, but within the first 2 years, RR was 1.1 (95% CI 1.04 -1.25). ♦♦ ♦♦ ♦ Conclusions: In The Netherlands, transplantation is a main reason to stop PD treatment. The incidence of PD technique failure is at its highest during the earliest months after treatment initiation and decreases later due to fewer catheter and abdominal complications as well as less influence of psychosocial factors. Risk factors for PD discontinuation are those responsible for patient survival: age, cardiovascular disease, diabetes, and rGFR.

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Section: Discussionsupporting

confidence: 74%

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

et al. 2010

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“…Only a few studies have explored the relationship between mechanical complications and technique survival in PD patients. Two observational studies revealed no negative influence of hernia formation on the dropout rates (23,24). However, hernia formation during PD therapy was associated with a 15% increased risk of PD withdrawal in our study (p = 0.012).…”

Section: Discussioncontrasting

confidence: 55%

The Risk Factors and the Impact of Hernia Development on Technique Survival in Peritoneal Dialysis Patients: A Population-Based Cohort Study

Yang

Liu

et al. 2015

Perit Dial Int

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“…Although our multivariable adjusted hazard ratio of 1.37 is smaller than their pooled estimate, our diabetes sample had relatively good glycaemic control, and only 20% of patients with diabetes had HbA 1c levels ≥7.3% (fifth quintile). Although actual glycaemic control was not described in the original articles cited in their review [16][17][18][19][20][21][22][23][24][25][26], the different glycaemic control may explain the different estimates of mortality risk.…”

Section: Discussionmentioning

confidence: 99%

Diabetes, glycaemic control and mortality risk in patients on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study

et al. 2007

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Aims/hypothesis There are few data on the target level of glycaemic control among patients with diabetes on haemodialysis. We investigated the impact of glycaemic control on mortality risk among diabetic patients on haemodialysis. Subjects and methods Data were analysed from the Dialysis Outcomes Practice Pattern Study (DOPPS) for randomly selected patients on haemodialysis in Japan. The diagnosis of diabetes at baseline and information on clinical events during follow-up were abstracted from the medical records. A Cox proportional hazards model was used to evaluate the association between presence or absence of diabetes, glycaemic control (HbA 1c quintiles) and mortality risk. Results Data from 1,569 patients with and 3,342 patients without diabetes on haemodialysis were analysed. Among patients on haemodialysis, those with diabetes had a higher mortality risk than those without (multivariable hazard ratio 1.37, 95% CI 1.08-1.74). Compared with those in the bottom quintile of HbA 1c level, the multivariable-adjusted hazard ratio for mortality was not increased in the bottom second to fourth quintiles of HbA 1c (HbA 1c 5.0-5.5% to 6.2-7.2%), but was significantly increased to 2.36 (95% CI 1.02-5.47) in the fifth quintile (HbA 1c ≥7.3%). The effect of poor glycaemic control did not statistically correlate with baseline mortality risk (p=0.27). Conclusions/interpretation Among dialysis patients, poorer glycaemic control in those with diabetes was associated with higher mortality risk. This suggests a strong effect of poor glycaemic control above an HbA 1c level of about 7.3% on mortality risk, and that this effect does not appear to be influenced by baseline comorbidity status.

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Long-Term Outcome in Continuous Ambulatory Peritoneal Dialysis: A 10-Year Survey by the Italian Cooperative Peritoneal Dialysis Study Group

Cited by 88 publications

References 3 publications

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

The Risk Factors and the Impact of Hernia Development on Technique Survival in Peritoneal Dialysis Patients: A Population-Based Cohort Study

Diabetes, glycaemic control and mortality risk in patients on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study

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