Outcome in Patients on Continuous Ambulatory Peritoneal Dialysis and Haemodialysis: 4-Year Analysis of a Prospective Multicentre Study

Gokal, Ram; King, Jennie; Bogle, Stephen; Marsh, Frank; Oliver, David K.; Jakubowski, Christopher; Hunt, Linda; Baillod, R. A.; Ogg, C S; Ward, M. K.; Wilkinson, Robert W.

doi:10.1016/s0140-6736(87)91544-3

Cited by 204 publications

(42 citation statements)

References 9 publications

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“…KEY WORDS: Hemodialysis; hospitalization. P eople with kidney failure have a high burden of comorbid illness (1) and consume a disproportionate share of resources (2,3), including hospital beds (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Hospitalization rates are a relevant consideration when choosing or recommending a dialysis modality, because those rates affect quality of life for patients (15,16), inform resource allocation (for example, the number of inpatient beds earmarked for a dialysis program), and influence the cost of caring for the dialysis population (2).…”

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confidence: 99%

“…The data about relative rates of hospitalization for people treated with peritoneal dialysis (PD) and hemodialysis (HD) are conflicting (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Given that many jurisdictions around the world are promoting PD and that a randomized comparison is not likely to be successful, efforts to reduce bias in observational studies are important.…”

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confidence: 99%

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Impact of Modality Choice on Rates of Hospitalization in Patients Eligible for Both Peritoneal Dialysis and Hemodialysis

et al. 2014

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♦ Background: Hospitalization rates are a relevant consideration when choosing or recommending a dialysis modality. Previous comparisons of peritoneal dialysis (PD) and hemodialysis (HD) have not been restricted to individuals who were eligible for both therapies. ♦ Methods: We conducted a multicenter prospective cohort study of people 18 years of age and older who were eligible for both PD and HD, and who started outpatient dialysis between 2007 and 2010 in four Canadian dialysis programs. Zero-inflated negative binomial models, adjusted for baseline patient characteristics, were used to examine the association between modality choice and rates of hospitalization. ♦ Results: The study enrolled 314 patients. A trend in the HD group toward higher rates of hospitalization, observed in the primary analysis, became significant when modality was treated as a time-varying exposure or when the population was restricted to elective outpatient starts in patients with at least 4 months of pre-dialysis care. Cardiovascular disease, infectious complications, and elective surgery were the most common reasons for hospital admission; only 23% of hospital stays were directly related to complications of dialysis or kidney disease. ♦ Conclusions: Efforts to promote PD utilization are unlikely to result in increased rates of hospitalization, and efforts to reduce hospital admissions should focus on potentially avoidable causes of cardiovascular disease and infectious complications.

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Impact of Modality Choice on Rates of Hospitalization in Patients Eligible for Both Peritoneal Dialysis and Hemodialysis

et al. 2014

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“…The percent contribution of cardiovascular death to the overall mortality of the dialysis population is not significantly different between patients receiving CAPD and patients receiving HD. Several large European studies estimated cardiovascular pathology to be responsible for 27%-56% of the deaths of patients on CAPD and 25%-44% of the deaths of patients on HD in series, [4][5][6] and in the United States it is estimated to cause around 45% of the deaths of patients on dialysis by either technique. 7 Many studies have found CAPD patients to have a more atherogenic lipoprotein profile than do HD patients.…”

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confidence: 99%

“…5 The percent contribution of cardiovascular death to the overall mortality of the dialysis population is not significantly different between patients treated with chronic hemodialysis and patients treated with chronic peritoneal dialysis. Some European studies have estimated cardiovascular pathology to be responsible for 27%-56% of the deaths of patients on CAPD and for 25%-44% of the deaths of patients on hemodialysis [4][5][6] ; in the United States it is responsible for around 45% of the deaths of patients receiving dialysis by either technique. 7 High-resolution B-mode ultrasonography is increasingly used in epidemiologic and clinical research to noninvasively study the atherosclerotic process in the carotid artery.…”

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Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

Cengiz¹,

Dolu²

2007

Dialysis & Transplantation

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BACKGROUND: Although some studies have found that myocardial infarction and cerebrovascular disease are more common in patients receiving continuous ambulatory peritoneal dialysis (CAPD) than in patients receiving hemodialysis (HD), the results of other studies have not supported these findings. Studies comparing patients receiving HD with patients receiving CAPD have had conflicting results.OBJECTIVE: The aims of this study were to compare the atherosclerotic changes in CAPD and HD patients and to assess which factors might be responsible for atherosclerosis in dialysis patients.METHODS: Enrolled in the study were 33 patients receiving HD, 32 patients receiving CAPD, and 33 controls for a total of 98 participants. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein, lipoprotein (a) (Lp[a]), apolipoprotein A-I, apolipoprotein B (Apo B), apolipoprotein E (Apo E), albumin, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, intact parathyroid hormone (iPTH), and ferritin levels were obtained from all patients. Carotid intima-media thickness (CIMT) and plaque number were calculated using B-mode ultrasonography.RESULTS: Serum TG, Lp(a), Apo B, hs-CRP, fibrinogen, ferritin, and iPTH levels were significantly higher in the dialysis groups than in the control group; whereas HDL, Apo E, and albumin levels were decreased (p Ͻ .05); the others were same in the all groups. However, there was no difference between the HD and CAPD groups in the other lipid parameters except Lp(a) (p Ͻ .05). CIMT and plaque number of the patients treated with dialysis were higher than those of the control group (p Ͻ .01), but were not significantly different between the 2 dialysis groups (p Ͼ .05). CIMT and plaque number were positively correlated with age (r ϭ 0.43; p Ͻ .05) and hs-CRP level (r ϭ 0.40; p Ͻ .05) and negative correlated with serum albumin and hs-CRP levels (r ϭ Ϫ0.37, p Ͻ .05; and r ϭ Ϫ0.25; p Ͻ .05, respectively).CONCLUSIONS: Serum Apo B and Lp(a) levels were higher in the CAPD patients than in the HD patients. CIMT and plaque number were positively correlated with age and hs-CRP level and negatively correlated with serum albumin and hs-CRP levels.

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“…Their rate of cardiovascular mortality is approximately 50%-five to 10 times higher than in the general population. [1][2][3][4] EVorts to optimise the medical management of these patients in order to improve their quality of life and survival prospects are thus warranted.…”

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confidence: 99%

An unusual palliative shunt for cyanotic congenital heart disease

Sreeram¹,

Henneveld²,

Hitchcock³

1997

Heart

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Objective-To assess the rate of angiographic restenosis in patients with end stage renal disease after elective coronary angioplasty. Design-A retrospective case-control study of 20 patients with end stage renal disease and 20 sex and age matched controls without renal disease, who had undergone primarily successful coronary angioplasty. Control coronary angiography was performed regardless of worsening or renewed incidence of anginal symptoms. Main outcome measures-Group

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Outcome in Patients on Continuous Ambulatory Peritoneal Dialysis and Haemodialysis: 4-Year Analysis of a Prospective Multicentre Study

Cited by 204 publications

References 9 publications

Impact of Modality Choice on Rates of Hospitalization in Patients Eligible for Both Peritoneal Dialysis and Hemodialysis

Impact of Modality Choice on Rates of Hospitalization in Patients Eligible for Both Peritoneal Dialysis and Hemodialysis

Comparison of atherosclerosis and atherosclerotic risk factors in patients receiving hemodialysis and peritoneal dialysis

An unusual palliative shunt for cyanotic congenital heart disease

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