Clinical Outcomes of Peritoneal Dialysis Patients Transferred from Hemodialysis: A Matched Case–Control Study

Zhang, Li; Cao, Tao; Li, Zhibin; Wen, Qiong; Lin, Jianxiong; Zhang, Xiaodan; Guo, Qunying; Yang, Xiao; Yu, Xueqing; Mao, Haiping

doi:10.3747/pdi.2011.00125

Cited by 11 publications

(17 citation statements)

References 34 publications

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“…Patient and technique survival are some of the most important indices in the assessment of the substitutive therapies; in our study, the comparison between both groups did not show statistical differences. Similar findings were observed by Zhang and coworkers [ 10 ]. Residual renal function plays an important role in the solute clearance and in fluids balance in the dialysis population; Heaf et al inferred that preservation of the RRF in peritoneal dialysis could be a cause of better survival in the first 2 years of dialysis treatment regarding HD [ 38 ].…”

Section: Discussionsupporting

confidence: 92%

“…Chaudhary et al, among others, described the advantages of peritoneal dialysis as the first modality and the reasons of underutilisation [ 14 ]. Some studies show the outcome of patients transferred from peritoneal dialysis to haemodialysis, but long-term studies analysing the outcome of patients transferred from haemodialysis to peritoneal dialysis are sparse [ 7 – 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…In PD, comparisons among diabetic and nondiabetic and anuric patients and patients with residual renal function are frequent, but comparisons between patients undergoing PD as first option versus PD as a second option after haemodialysis are scarce [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Peritoneal Dialysis as a First versus Second Option after Previous Haemodialysis: A Very Long-Term Assessment

Barone¹,

Cámpora²,

Gimenez³

et al. 2014

International Journal of Nephrology

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For renal replacement therapy, overall survival is more important than the choice of currently available individual therapy. Objectives. To compare patients and technique survival on peritoneal dialysis as first treatment (PDF) versus after previous haemodialysis (HDPD) and other indicators of follow-up. Methods. We prospectively studied 110 incident patients, during the period from August 4, 1993, to June 30, 2012, for patients and technique survival (Kaplan-Meier) (log rank P < 0.05). Results. Groups: (A) PDF: 37 patients, 24 females, age: 52.2 ± 14.9 years old, time at risk: 2123 patient-months (p/m), mean: 57 ± 42 months; (B) HDPD: 73 patients, 42 females, age: 52.45 ± 14.7 years old, time in haemodialysis: 3569.2 (p/m), range: 3–216 months, mean: 49 ± 45 months, time at risk in PD: 3700 (p/m), mean: 51 ± 49 months. Patients' survival: (A) PDF: 100%, 76.6%, 65.6%, and 19.7%; (B) HDPD: 95.4%, 65.6%, 43%, and 43% at 12, 60, 120, and 144 months, respectively, P = 0.34. Technique: (A) PDF: 100%, 90%, 59.8%, and 24%; (B) HDPD: 94%, 75%, 32%, and 32% at 12, 60, 120, and 144 months, respectively, P = 0.40. Conclusions. Comparable patient and technique survival were observed. Peritoneal dialysis enables a greater extension of renal replacement therapy for patients with serious difficulties continuing with haemodialysis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Peritoneal Dialysis as a First versus Second Option after Previous Haemodialysis: A Very Long-Term Assessment

Barone¹,

Cámpora²,

Gimenez³

et al. 2014

International Journal of Nephrology

View full text Add to dashboard Cite

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“…In a single centre study from China on 475 patients, cardiovascular problems were reported to be the main reason (45.45%) and included systemic hypotension (13.33%), intra‐dialytic hypotension (26.67%), heart failure (20%), ischemic heart disease (33.33%), arrhythmia (26.67%) and other unacceptable symptoms (33.33%). The next common reasons included vascular access problems (24.24%) and patient choice in only 15.15% . 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%) .…”

Section: Discussionmentioning

confidence: 99%

“…The next common reasons included vascular access problems (24.24%) and patient choice in only 15.15%. 11 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%). 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%).…”

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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Outcomes after transfer from hemodialysis to peritoneal dialysis vs peritoneal dialysis as initial therapy: A systematic review and meta‐analysis

Wang

Zeng

Liu

et al. 2020

Seminars in Dialysis

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Outcomes of patients who are transferred to peritoneal dialysis (PD) after an initial phase of hemodialysis (HD) compared to patients initiating dialysis with PD is controversial. We performed a systematic literature to assess evidence. Primary outcome was overall survival (OS), while secondary outcomes were technique failure, mortality and peritonitis. Meta‐analysis indicated that PD initial group had significantly better OS as compared to HD to PD group. Pooled analysis demonstrated a significantly higher probability of technique failure in the HD to PD group as compared to PD initial group. Mortality rate in HD to PD group was significantly higher but there was no statistically significant difference in peritonitis rates between the two groups. On meta‐regression analysis, transfer from HD to PD due to vascular access problems was associated with significantly reduced probability of OS. Our study indicates that patients transferred from HD to PD after at least 3 months of HD therapy may have reduced OS as compared to patients initiating dialysis with PD. Our findings lend some support to PD first policy and the need for heightened vigilance among the switched patients to monitor for adverse events.

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Clinical Outcomes of Peritoneal Dialysis Patients Transferred from Hemodialysis: A Matched Case–Control Study

Cited by 11 publications

References 34 publications

Peritoneal Dialysis as a First versus Second Option after Previous Haemodialysis: A Very Long-Term Assessment

Peritoneal Dialysis as a First versus Second Option after Previous Haemodialysis: A Very Long-Term Assessment

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

Outcomes after transfer from hemodialysis to peritoneal dialysis vs peritoneal dialysis as initial therapy: A systematic review and meta‐analysis

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