Background To analyze the health-related quality of life associated with the conversion of dialysis modality among end-stage renal disease patients in China. Methods Patients were recruited from hospitals and a dialysis center in Kunshan, China. Patients converting from continuous ambulatory peritoneal dialysis to automated peritoneal dialysis were recruited as the observation group (n = 64), and patients continuing with continuous ambulatory peritoneal dialysis treatment were included in the control group (n = 64) after matching in this retrospective cohort study. Their health-related quality of life was measured using the kidney disease quality of life instrument in 2019 and 2020, respectively. Baseline socio-demographic characteristics and clinical data were collected in 2019. The before-and-after cross-group comparisons of subscale scores of two groups were conducted using a Student‘s t-test. Multiple linear regression models were fitted to identify the factors associated with the change of each scale. Results The health-related quality of life scores of the two groups was comparable in baseline, while the observation group had higher scores in Physical Component Summary (51.92 ± 7.50), Kidney Disease Component Summary (81.21 ± 8.41), Symptoms (90.76 ± 6.30), Effects (82.86 ± 11.42), and Burden (69.04 ± 15.69) subscales after one year. In multivariate regression analysis, the change of Physical Component Summary was significantly associated with conversion to APD (β = 11.54, 95% CI [7.26–15.82]); the change of Mental Component Summary with higher education (β = − 5.96, 95% CI [−10.18–−1.74]) and CCI (>2) (β = 5.39, 95% CI [1.05–9.73]); the change of Kidney Disease Component Summary with conversion to APD (β = 15.95, 95% CI [10.19–21.7]) and age (>60 years) (β = − 7.36, 95% CI [−14.11–−0.61]); the change of Symptoms with CCI (>2) (β = 7.96, 95% CI [1.49–14.44]); the change of Effects with conversion to APD (β = 19.23, 95% CI [11.57–26.88]); and the change of Burden with conversion to APD (β = 22.40, 95% CI [13.46–31.34]), age (>60 years) (β = − 12.12, 95% CI [−22.59–−1.65]), and higher education (β = − 10.38, 95% CI [−19.79–−0.98]). Conclusions The conversion of dialysis modality had a significant impact on the scores of most subscales. Patients converting from continuous ambulatory peritoneal dialysis to automated peritoneal dialysis generally had improved health-related quality of life scores.
Methods Using a retrospective 15‐year cohort, stratified by age, this study aimed to analyze the effect of dialysis modality on mortality of ESRD patients in a city of China. Study data were from the medical insurance information system of Kunshan, Jiangsu Province of China, and 1484 patients with ESRD, enrolled from 1 January 2005 to 31 December 2019 were included in this study. The primary outcome event was all‐cause mortality, which was calculated in months. Dialysis modalities included hemodialysis (HD) and peritoneal dialysis (PD). Survival analysis and competing‐risk regression model were performed in this study. Results HD costs significantly higher medical expense than the PD treatment regimen. The mean survival time was 121.28 (SE = 3.020) months for HD patients, while that was 94.68 (SE = 3.534) months for the PD. Ten‐year survival rates of the young, middle‐aged, and elderly were 0.82, 0.56, and 0.26, respectively. For the young (SHR = 0.869, 95% CI: 0.525–1.436) and middle‐aged (SHR = 0.715, 95% CI: 0.484–1.057) ESRD patients, different dialysis modalities exhibited no statistical significance on the survival, but for the elderly, HD had a lower risk of mortality than PD (SHR = 0.747, 95% CI: 0.581–0.961). Conclusion Survival of the young and middle‐aged ESRD patients was superior to that of the elderly. Considering both survival time and direct medical costs, we recommend that PD could be a better choice for young and middle‐aged ESRD patients, while HD may be suitable for older patients.
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