Patient outcome in primary peritoneal dialysis patients versus those transferred from hemodialysis and transplantation

Najafi, Iraj; Hosseini, Mostafa; Atabac, Shahnaz; Sanadgol, H.; Majelan, N Nouri; Seirafian, Shiva; Naghibi, Massih; Makhdoumi, K H; Saddadi, Fereshteh; Soleymanian, Tayebeh

doi:10.1007/s11255-011-0068-x

Cited by 8 publications

(12 citation statements)

References 29 publications

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“…Figure 1 presents the study flow-chart. We identified 20 studies for full text analysis of which 12 fulfilled the inclusion criteria [10,11,[14][15][16][17][18][19][20][21][22][23]. Table 1 lists the details of all the studies included (all retrospective in nature and reporting data from different world regions).…”

Section: Resultsmentioning

confidence: 99%

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Meng

et al. 2021

Renal Failure

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Purpose: The influence of prior failed kidney transplants on outcomes of peritoneal dialysis (PD) is unclear. Thus, we conducted a systematic review and meta-analysis to compare the outcomes of patients initiating PD after a failed kidney transplant with those initiating PD without a prior history of kidney transplantation. Methods: We searched PubMed, Embase, CENTRAL, and Google Scholar databases from inception until 25 November 2020. Our meta-analysis considered the absolute number of events of mortality, technical failures, and patients with peritonitis, and we also pooled multi-variable adjusted hazard ratios (HR). Results: We included 12 retrospective studies. For absolute number of events, our analysis indicated no statistically significant difference in technique failure [RR, 1.14; 95% CI, 0.80-1.61; I 2 ¼52%; p ¼ 0.48], number of patients with peritonitis [RR, 1.13; 95% CI, 0.97-1.32; I 2 ¼5%; p ¼ 0.11] and mortality [RR, 1.00; 95% CI, 0.67-1.50; I 2 ¼63%; p ¼ 0.99] between the study groups. The pooled analysis of adjusted HRs indicated no statistically significant difference in the risk of technique failure [HR, 1.25; 95% CI, 0.88-1.78; I 2 ¼79%; p ¼ 0.22], peritonitis [HR, 1.04; 95% CI, 0.72-1.50; I 2 ¼76%; p ¼ 0.85] and mortality [HR, 1.24; 95% CI, 0.77-2.00; I 2 ¼66%; p ¼ 0.38] between the study groups. Conclusion: Patients with kidney transplant failure initiating PD do not have an increased risk of mortality, technique failure, or peritonitis as compared to transplant-naïve patients initiating PD. Further studies are needed to evaluate the impact of prior and ongoing immunosuppression on PD outcomes.

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Section: Resultsmentioning

confidence: 99%

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Meng

et al. 2021

Renal Failure

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“…Similarly, in a study involving 417 Belgium patients, 80 transferred from HD to PD, cardiovascular disease was considered to be the main cause of transfer (40%), followed by problems of vascular access (25%), blood pressure (25%) and personal choice (10%) . The Iranian registry data showed that the major causes of switching from HD to PD were vascular access failure (45%) and cardiovascular intolerance to HD (34%) . Since majority of transfers from HD to PD in our analysis occurred within the first year after commencing RRT, it is likely that patients transferring to PD for reasons of patient preference are related to late referral, and received limited pre‐dialysis education and pre‐ESKD care.…”

Section: Discussionmentioning

confidence: 99%

“…10 The Iranian registry data showed that the major causes of switching from HD to PD were vascular access failure (45%) and cardiovascular intolerance to HD (34%). 12 Since majority of transfers from HD to PD in our Table 5 Comparisons of survival of patients switched from haemodialysis to peritoneal dialysis (PD) and those started and remained on PD analysis occurred within the first year after commencing RRT, it is likely that patients transferring to PD for reasons of patient preference are related to late referral, and received limited pre-dialysis education and pre-ESKD care. In ANZDATA annual report in 2015, 17% of Australian and 13% of New Zealand incident patients commencing dialysis were referred to nephrologists less than 3 months before initiation of RRT.…”

Section: Discussionmentioning

confidence: 99%

Predictors and outcomes of patients switching from maintenance haemodialysis to peritoneal dialysis in Australia and New Zealand: Strengthening the argument for ‘peritoneal dialysis first’ policy

et al. 2019

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Aims (1) To determine incidence and reasons for transfer from maintenance haemodialysis (HD) to peritoneal dialysis (PD); (2) To compare mortality of HD patients transferred to PD with those who initiated and remained on PD. Methods A 1:2 matched cohort of ANZDATA included patients dialyzing over 3 months dividing into 2 groups. Group A (HD to PD) was compared to group B (initiated and remained on PD) and matched PD group (Group C). We compared mortality by total time on dialysis regardless of modality. Results Of 20 882 patients, there were 911 in group A. The transfer rate from HD to PD was 5%, 6.7% and 7.4% at 1,4 and 8 years, respectively. Median time before switching of patients in Group A was 5.9 (4.0–10.9) months. The commonest reported reason for transfer was patient preference (63.8%). Mortality was significantly worse in Group A if dialysis vintage was ≤6 months and from 12–24 months (P < 0.05), whereas there was no difference in mortality if dialysis vintage was 6–12 months or ≥ 24 months (P = 0.073 and P = 0.153, respectively). Overall, mortality of patients in group A was higher than that in group B after adjusting for age, race, chronic lung disease, peripheral vascular disease, cerebrovascular disease, diabetes, haemoglobin and phosphate (hazard ratio = 1.335, 95% confidence interval = 1.172–1.520). Conclusion Haemodialysis patients transferred to PD had higher mortality than those initiated on PD, strengthening the case for PD first policy.

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“…Peritoneal dialysis is one of the renal replacement therapy options in patients with end-stage renal disease. Peritoneal dialysis is a safe and effective treatment modality even in elderly and patients transferred from transplantation or hemodialysis [7,8]. The fast PET was described in 1990 in order to decrease work load and to offer a more practical and easy-to-perform testing method and the test was later validated to assess peritoneal membrane functions [4].…”

Section: Discussionmentioning

confidence: 99%

The Fast Peritoneal Equilibration Test First and Second Hour Results

et al. 2015

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Introduction. The Peritoneal Equilibration Test (PET) is employed to assess peritoneal membrane transport function. The purpose of the test is to determine the optimal peritoneal dialysis regimen. The performance of the test, which is conducted over 4 hours, is time consuming both for the nurses and the patient. There have been studies to validate an approved short version of the original PET protocol, and all have yielded different results. We evaluated the concordance between the 1-hour, 2-hour and 4-hour (classical) test results of the fast PET. Methods. The study included 32 patients (20 males and 12 females). The patients underwent the 4-hour fast PET test, and the dialysate-to-plasma ratio of creatinine concentration (D/Pcrea) was determined. The standard deviation was added to or subtracted from the mean D/Pcrea ratios at hours 1, 2, and 4 to determine transport groups. Results. The mean age of the patients was 51.4±16.7 years. Mean D/Pcrea ratios at hours 1, 2, and 4 were 0.41±0.07, 0.54±0.10, and 0.69+0.12, respectively. There was a strong correlation between the 4-hour D/Pcrea ratio and 1-hour (r=0.756, p<0.001) and 2-hour (r=0.867, p<0.001) D/Pcrea ratios. Seventeen patients (53%) were in the same transport group at hours 1, 2, and 4. Eighteen patients (56%) at 1 hour and 24 patients (75%) at 2 hours fell into the same transport group at 4 hours. The patients that fell into different transport groups at different time points showed a shift to a lower or higher transport group. Conclusions. Two-hour fast PET gives promising results for clinical assessment purposes.

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Patient outcome in primary peritoneal dialysis patients versus those transferred from hemodialysis and transplantation

Abstract: We concluded that PD could be considered safe for patients experiencing complications on HD, as well as for those with renal transplantation.

Cited by 8 publications

References 29 publications

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Comparison of outcomes of peritoneal dialysis between patients after failed kidney transplant and transplant-naïve patients: a meta-analysis of observational studies

Predictors and outcomes of patients switching from maintenance haemodialysis to peritoneal dialysis in Australia and New Zealand: Strengthening the argument for ‘peritoneal dialysis first’ policy

The Fast Peritoneal Equilibration Test First and Second Hour Results

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