Predictors of Peritonitis, Hospital Days, and Technique Survival for Peritoneal Dialysis Patients in a Managed Care Setting

Kumar, Victoria A.; Sidell, Margo; Yang, Wanting; Jones, Jason P.

doi:10.3747/pdi.2012.00165

Cited by 33 publications

(43 citation statements)

References 23 publications

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“…Although a higher risk for blacks has been reported in several but not all studies of patients treated with PD, our investigation is the first to show this for patients undergoing home HD. [6][7][8][9] In contrast, Asians and others treated with PD had a lower risk for transfer to in-center HD compared with whites. Transfer to in-center HD, also referred to as technique failure, often results from an intercurrent therapy-related complication (such as peritonitis with PD), change in health status or social circumstances that precludes self-care, or patient burnout.…”

Section: Discussionmentioning

confidence: 89%

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

Mehrotra

Soohoo

Rivara

et al. 2015

JASN

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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.

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Section: Discussionmentioning

confidence: 89%

“…Furthermore, there is substantial paucity of data for racial/ethnic differences in outcomes with home dialysis, such as the risk for death or transfer to in-center HD. [6][7][8][9] There are no such data for Hispanics or Asians treated with PD and outcomes by race/ ethnicity for any population of patients treated with home HD.…”

mentioning

confidence: 99%

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

Mehrotra

Soohoo

Rivara

et al. 2015

JASN

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“…Comorbidity was scored on the number of comorbid conditions using the comorbidity index. 22 Angiogenesis markers including VEGF, Flk-1, Ang-2, Tie-2, and Tsp-1 from peritoneal dialysate effluent (PDE) were analyzed by an enzyme-linked immunosorbent assay (ELISA) kit (Quantikine Õ ; R&D Systems, Minneapolis, MN) according to the manufacturer's directions. All PDE samples for the biomarker assessment were collected from the overnight PDE (from exchanges with 2 L 2.5% Dianeal dialysate) at the night preceding the PET and were stored at À70 C until analysis.…”

Section: Demographic and Laboratory Measurementsmentioning

confidence: 99%

Supplementation with high-dose trans-resveratrol improves ultrafiltration in peritoneal dialysis patients: a prospective, randomized, double-blind study

2016

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Background Ultrafiltration (UF) failure mostly contributes to technical failure in peritoneal dialysis (PD) patients, and one of its responsible factors is peritoneal angiogenesis. Resveratrol has been proposed to have an angiogenesis-ameliorating effect on tumor patients. We hypothesize transresveratrol has beneficial effects on angiogenesis-related markers in PD patients. Methods In this prospective, randomized, and double-blind trial, 72 patients were randomly assigned to 12-week treatment of low-dose or high-dose (150 or 450 mg/d) trans-resveratrol or a placebo. Visits were scheduled at 0, 4, 8, and 12 weeks after treatment. Clinical indices including 24-hour UF volume, UF rate, 24-hour urine volume, residual renal function, and dialysis adequacy (kt/v) were measured. Angiogenesis markers including vascular endothelial growth factor (VEGF), fetal liver kinase-1 (Flk-1), angiopoietin-2 (Ang-2), tyrosine kinase 2 (Tie-2), and thrombospondin-1 (Tsp-1) in peritoneal effluent were also assessed by enzyme-linked immunosorbent assay. Results Finally, 64 out of 72 patients were analyzed, 18 in the high-dose group, 22 in the low-dose group, and 24 in the placebo group. Over the 12-week period, patients in the high-dose group [mean change from baseline (95% CI): 171.4 (141.3-201.5) (mL), p ¼ 0.003 (Net UF); 11.3(10.5-12.1) (mL/h), p ¼ 0.02 (UF rate)] or the low-dose group [mean change from baseline (95% CI: 98.1 (49.5-146.7) (mL), p ¼ 0.007 (Net UF); 6.5 (4.4-8.6) (mL/h), p ¼ 0.04 (UF rate)] versus the placebo group had a significantly greater improvement in mean net UF volume and UF rate. The appearance rates of VEGF, Flk-1, and Ang-2 were more significantly reduced (appearance rates of Tie-2 and Tsp-1 increased) in the high-dose group versus the placebo group, but not in the low-dose group. Conclusion Supplementation with trans-resveratrol is beneficial to improve ultrafiltration in PD patients, and high-dose supplementation may improve ultrafiltration by ameliorating angiogenesis induced by conventional lactate-buffered PD solutions.

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“…Therefore, SCR becomes an important strategy for retaining patients on PD therapy. In the present report, patients undergoing SCR had a median technique survival of 5.1 years, a better outcome than the 2.1 -2.7 years median technique survival described for general PD populations (17)(18)(19).…”

Section: Discussionmentioning

confidence: 67%

Simultaneous Catheter Replacement for Infectious and Mechanical Complications without Interruption of Peritoneal Dialysis

Crabtree

Siddiqi

2015

Perit Dial Int

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Predictors of Peritonitis, Hospital Days, and Technique Survival for Peritoneal Dialysis Patients in a Managed Care Setting

Abstract: Neither race nor socio-economic status predicted technique survival or hospital days in our study. Female sex and higher education were the only two variables studied that had an association with peritonitis.

Cited by 33 publications

References 23 publications

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

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

Supplementation with high-dose trans-resveratrol improves ultrafiltration in peritoneal dialysis patients: a prospective, randomized, double-blind study

Simultaneous Catheter Replacement for Infectious and Mechanical Complications without Interruption of Peritoneal Dialysis

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