Comparison of hemodialysis and peritoneal dialysis survival in The Netherlands

Liem, Ylian S.; Wong, John B.; Hunink, M. G. Myriam; Charro, Frank de; Winkelmayer, Wolfgang C.

doi:10.1038/sj.ki.5002014

Cited by 179 publications

(142 citation statements)

References 27 publications

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“…Patient survival on PD in The Netherlands has somewhat improved over the past 10 years (3). The rate we found corresponds with that found in another national study (21), is higher than rates reported from some American studies (4,7), and is somewhat lower than in Asian studies (22,23).…”

contrasting

confidence: 50%

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

et al. 2010

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♦♦ ♦♦ ♦ Background: Peritoneal dialysis (PD) technique failure is high compared to hemodialysis (HD). There is a lack of data on the impact of duration of PD treatment on technique survival and on whether there is a difference in risk factors with respect to early and late failure. The aim of this study was to clarify these issues by performing a timedependent analysis of PD technique and patient survival in a large cohort of incident PD patients. ♦♦ ♦♦ ♦ Methods: We analyzed 709 incident PD patients participating in the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD), who started their treatment between 1997 and 2007. We compared technique and patient survival on PD in 4 periods of follow-up: within the first 3 months, and after 3 -12 months, 12 -24 months, and 24 -36 months of treatment. Cox proportional hazards model was used to analyze survival on PD and technique failure. Risk factors were also identified by comparing patients that were transferred to HD with those that remained on PD. Incidence rates for every cause of dropout for each period of follow-up were calculated to establish their trends with respect to PD treatment duration. ♦♦ ♦♦ ♦ Results: There was a significant increase in transplantation rate after the first year of treatment. The rate of switching to HD was highest during the first 3 months and decreased afterward. One-, 2-and 3-year technique survival was 87%, 76%, and 66%, respectively. Age, diabetes, and cardiovascular disease appeared to be risk factors for death on PD or switch to HD: a 1-year increase in age was associated with a relative risk (RR) of PD failure of 1.04 [95% confidence interval (CI) 1.003 -1.06]; for diabetes, RR of stopping PD after 3 months of treatment increased from 1.8 (95% CI 1.1 -3) during the first year to 2.2 (95% CI 1.3 -4) after the second year; cardiovascular disease had a major impact in the earliest period (RR 2.5, 95% CI 1.2 -5) and had a stable influence further on (RR 2, 95% CI 1.1 -3.5).Loss of 1 mL/minute residual glomerular filtration rate (rGFR) appeared to be a significant predictor of PD failure after 3 months of treatment, but within the first 2 years, RR was 1.1 (95% CI 1.04 -1.25). ♦♦ ♦♦ ♦ Conclusions: In The Netherlands, transplantation is a main reason to stop PD treatment. The incidence of PD technique failure is at its highest during the earliest months after treatment initiation and decreases later due to fewer catheter and abdominal complications as well as less influence of psychosocial factors. Risk factors for PD discontinuation are those responsible for patient survival: age, cardiovascular disease, diabetes, and rGFR.

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confidence: 50%

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

et al. 2010

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“…25 An earlier Canadian registry-based study showed lower mortality rates among PD-compared with HD-treated patients among an incident cohort of 11,970 people. 13 A recent Dutch registry study 16 showed a substantial benefit to PD in early treatment among younger people without diabetes, with lesser benefit among other groups, with a subsequent change to increased longer term mortality associated with PD. Other groups have attempted comparisons but were limited by small numbers.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Dialysis Modality and Mortality

McDonald¹,

Marshall²,

Johnson³

et al. 2009

Journal of the American Society of Nephrology

283

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Mortality differences between peritoneal dialysis (PD) and hemodialysis (HD) are widely debated. In this study, mortality was compared between patients treated with PD and HD (including home HD) using data from 27,015 patients in the Australia and New Zealand Dialysis and Transplant Registry, 25,287 of whom were still receiving PD or HD 90 d after entry into the registry. Overall mortality rates were significantly lower during the 90-to 365-d period among those being treated with PD at day 90 (adjusted hazard ratio [HR] 0.89; 95% confidence interval [CI] 0.81 to 0.99]; P Ͻ 0.001). This effect, however, varied in direction and size with the presence of comorbidities: Younger patients without comorbidities had a mortality advantage with PD treatment, but other groups did not. After 12 mo, the use of PD at day 90 was associated with significantly increased mortality (adjusted HR 1.33; 95% CI 1.24 to 1.42; P Ͻ 0.001). In a supplementary as-treated analysis, PD treatment was associated with lower mortality during the first 90 d (adjusted HR 0.67; 95% CI 0.56 to 0.81; P Ͻ 0.001). These data suggest that the effect of dialysis modality on survival for an individual depends on time, age, and presence of comorbidities. Treatment with PD may be advantageous initially but may be associated with higher mortality after 12 mo.

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“…More recently, there have been at least three large national database studies comparing PD and HD survival. [29][30][31] These studies do not significantly affect the overall conclusions of the Vonesh review given earlier, as they essentially build upon the scientific equipoise in this area.…”

Section: Mortality Studies In Dialysis Patients: Are Diabetic Pd Patimentioning

confidence: 99%

Reducing Cardiometabolic Risk in Peritoneal Dialysis Patients: Role of the Dialysis Solution

Holmes

2009

J Diabetes Sci Technol

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Peritoneal dialysis (PD) is a well-established form of therapy for stage 5 chronic kidney disease requiring renal replacement therapy. D-Glucose has been used successfully for several decades as the osmotic agent employed in dialysis solutions to achieve adequate fluid removal. The absorption of 100–200 grams of glucose per day has been suggested as potentially increasing cardiometabolic risk, particularly in patients with diabetes. Supporting and undermining evidence for this hypothesis is reviewed, with a focus on the role of glucose absorption in changes in body composition, dyslipidemia, and glycemic control in diabetic PD patients. Clinical strategies to optimize fluid removal while minimizing the metabolic impact of glucose absorption are also discussed.

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Comparison of hemodialysis and peritoneal dialysis survival in The Netherlands

Cited by 179 publications

References 27 publications

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

Time-Dependent Reasons for Peritoneal Dialysis Technique Failure and Mortality

Relationship between Dialysis Modality and Mortality

Reducing Cardiometabolic Risk in Peritoneal Dialysis Patients: Role of the Dialysis Solution

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