The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis

Perl, Jeffrey; Davies, Simon; Lambie, Mark; Pisoni, Ronald L.; McCullough, Keith; Johnson, David W.; Sloand, James A.; Prichard, Sarah; Kawanishi, Hideki; Tentori, Francesca; Robinson, Bruce M.

doi:10.3747/pdi.2014.00288

Cited by 118 publications

(139 citation statements)

References 37 publications

(46 reference statements)

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“…The influence of RTM on technique failure rates has not been reported previously in PD, yet the improvements we found are consistent with observations from RTM in the home HD population (16). Notably, technique failure rates in all groups of our analysis were lower than many reports in the literature (17,18), which could be in part due to our definition of a sustained technique failure event that required .6 consecutive weeks of HD and appropriately did not count technique failures as composite outcomes including death. These findings could also be in part representative of patients included in our analysis being a highly select, healthier population compared to the overall PD population.…”

Section: Discussionsupporting

confidence: 91%

Remote Treatment Monitoring on Hospitalization and Technique Failure Rates in Peritoneal Dialysis Patients

et al. 2020

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Background An integrated kidney disease healthcare company implemented a peritoneal dialysis (PD) remote treatment monitoring (RTM) application in 2016. We assessed if RTM utilization associates with hospitalization and technique failure rates.Methods We used data from adult (age $18 years) patients on PD treated from October 2016 through May 2019 who registered online for the RTM. Patients were classified by RTM use during a 30-day baseline after registration. Groups were: nonusers (never entered data), moderate users (entered one to 15 treatments), and frequent users (entered .15 treatments). We compared hospital admission/day and sustained technique failure (required .6 consecutive weeks of hemodialysis) rates over 3, 6, 9, and 12 months of follow-up using Poisson and Cox models adjusted for patient/clinical characteristics.Results Among 6343 patients, 65% were nonusers, 11% were moderate users, and 25% were frequent users. Incidence rate of hospital admission was 22% (incidence rate ratio [IRR]50.78; P50.002), 24% (IRR50.76; P,0.001), 23% (IRR50.77; P#0.001), and 26% (IRR50.74; P#0.001) lower in frequent users after 3, 6, 9, and 12 months, respectively, versus nonusers. Incidence rate of hospital days was 38% (IRR50.62; P50.013), 35% (IRR50.65; P50.001), 34% (IRR50.66; P#0.001), and 32% (IRR50.68; P,0.001) lower in frequent users after 3, 6, 9, and 12 months, respectively, versus nonusers. Sustained technique failure risk at 3, 6, 9, and 12 months was 33% (hazard ratio [HR]50.67; P50.020), 31% (HR50.69; P50.003), 31% (HR50.69; P50.001), and 27% (HR50.73; P50.001) lower, respectively, in frequent users versus nonusers. Among a subgroup of survivors of the 12-month follow-up, sustained technique failure risk was 26% (HR50.74; P50.023) and 21% (HR50.79; P50.054) lower after 9 and 12 months, respectively, in frequent users versus nonusers.Conclusions Our findings suggest frequent use of an RTM application associates with less hospital admissions, shorter hospital length of stay, and lower technique failure rates. Adoption of RTM applications may have the potential to improve timely identification/intervention of complications.

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Section: Discussionsupporting

confidence: 91%

Remote Treatment Monitoring on Hospitalization and Technique Failure Rates in Peritoneal Dialysis Patients

et al. 2020

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“…Therefore, all efforts must be made to re-examine our findings prospectively. Perhaps the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) study may be able to shed light on the subject (it is noteworthy that Germany is not part of the study) [13]. As men outnumber women in both forms of dialysis this might reflect either disease specific factors (e.g.…”

Section: Discussionmentioning

confidence: 99%

Gender-Specific Differences in Peritoneal Dialysis

Kitterer

Segerer

Braun³

et al. 2017

Kidney Blood Press Res

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Background/Aims: Gender-specific differences between patients on renal replacement therapy have so far rarely been investigated. In the present study we aimed to describe gender-specific differences in a large cohort of peritoneal dialysis (PD) patients. Methods: Clinical information for all patients who started PD at our center has been collected since the start of the PD-program in 1979. We used Cox regression to examine associations between technique failure and gender. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Results: A total of 745 patients (315 women and 430 men with a median age of 57 years; IQR 43–67) started PD between 1979 and 2015 in our center. Women were significantly younger at PD start 54 (40-65) years vs. 58 (47-68) years, p<0.001. Within the last almost 15 years, more man than women started PD, but technical survival rates were significantly better in female compared to men (HR=0.662, CI 95% (0.496-0.885) P=0.005). Cardiovascular events were the main cause of death over the study period in both sexes, but decreased over time. Additionally, death due to PD-associated peritonitis decreased significantly over the three decades in both sexes. Conclusions: Our data suggest that technical survival rates were significantly better in female compared to men over three decades and death due to cardiovascular events and PD-associated peritonitis decreased significantly over the three decades in both sexes.

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“…A multi-centric international prospective cohort study has begun to identify modifiable and measurable PD practices associated with improved outcomes for patients. In this study, practices indicators or processes of care will be analysed at the patient level and at the centre level [18] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Prophylactic Antibiotics at Peritoneal Catheter Insertion on Early Peritonitis: Data from the Catheter Section of the French Language Peritoneal Dialysis Registry

et al. 2016

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Background: International guidelines recommend the use of a prophylactic antibiotic before the peritoneal dialysis (PD) catheter can be inserted. The main objective of this study was to assess whether this practice is associated with a lower risk of early peritonitis and to estimate the magnitude of the centre effect. Methods: A retrospective, multi-centric study was conducted, in which data from the French Language Peritoneal Dialysis Registry was analysed. Patients were separated into 2 groups based on whether or not prophylactic antibiotics were used prior to catheter placement. Results: Out of the 2,014 patients who had a PD catheter placed between February 1, 2012 and December 31, 2014, 1,105 were given a prophylactic antibiotic. In a classical logit model, the use of prophylactic antibiotics was found to protect the individual against the risk of early peritonitis (OR 0.67, 95% CI 0.49-0.92). However, this association lost significance in a mixed logistic regression model with centre as a random effect: OR 0.73 (95% CI 0.48-1.09). Covariates associated with the risk of developing early peritonitis were age over 65: OR 0.73 (95% CI 0.39-0.85), body mass index over 35 kg/m²: OR 1.99 (95% CI 1.13-3.47), transfer to PD due to graft failure: OR 2.24 (95% CI 1.22-4.11), assisted PD: OR 1.96 (95% CI 1.31-2.93), and the use of the Moncrief technique: OR 3.07 (95% CI 1.85-5.11). Conclusion: There is a beneficial effect of prophylactic antibiotic used prior to peritoneal catheter placement, on the occurence of early peritonitis. However, the beneficial effect could be masked by a centre effect.

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The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis

Cited by 118 publications

References 37 publications

Remote Treatment Monitoring on Hospitalization and Technique Failure Rates in Peritoneal Dialysis Patients

Remote Treatment Monitoring on Hospitalization and Technique Failure Rates in Peritoneal Dialysis Patients

Gender-Specific Differences in Peritoneal Dialysis

Efficacy of Prophylactic Antibiotics at Peritoneal Catheter Insertion on Early Peritonitis: Data from the Catheter Section of the French Language Peritoneal Dialysis Registry

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