Effect of cause and time of dropout on the residual GFR: A comparative analysis of the decline of GFR on dialysis

Misra, Madhukar; Vonesh, EF; Stone, Jon; Moore, Harold L.; Prowant, Barbara F.; Nolph, Karl D.

doi:10.1046/j.1523-1755.2001.059002754.x

Cited by 135 publications

(109 citation statements)

References 17 publications

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“…[15][16][17][18][19] Common features of these trials were that they were underpowered, did not consider nonlinear decline of renal function in their analytic models, and generally enrolled prevalent patients with lower baseline levels of renal function. As with other studies, 22,24 we observed that renal function decline over time was nonlinear, was most marked in the first year of PD, and tended to be slower with biocompatible fluid use in this first year (although not statistically significant). A possible renoprotective benefit of biocompatible (Balance) solution was reinforced by the finding of a significantly delayed onset of anuria (an alternative outcome measure of residual renal function decline) in this group.…”

Section: Discussionsupporting

confidence: 86%

“…Moreover, the use of a crossover study design to evaluate renal function was problematic, given the nonlinear decline of residual renal function over time. 22,23 Similar difficulties applied to a randomized crossover trial of bicarbonate-buffered dialysate versus conventional dialysate in 55 prevalent PD patients over 12 weeks. 14 More recently, the BalNet study group 12 reported that Balance solution was associated with a nonsignificant slower decline in renal function in 48 incident PD patients in four Korean centers compared with 43 patients receiving stay.safe solution.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes

Johnson

Brown

Clarke³

et al. 2012

Journal of the American Society of Nephrology

188

215

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes

Johnson

Brown

Clarke³

et al. 2012

Journal of the American Society of Nephrology

188

215

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“…Although there is no significant difference in 5-year survival of patients in contemporary cohorts, many of the earlier studies have shown a lower risk for death in the first 1-3 years after the start of dialysis. This finding has been attributed to better preservation of native renal function (29). It is possible, although not known, that PD patients may have greater native renal function at the time of transplantation, accounting for the lower risk for death after transplantation.…”

Section: Discussionmentioning

confidence: 99%

Dialysis Modality and Outcomes in Kidney Transplant Recipients

Molnar

Mehrotra

Duong³

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The influence of pretransplant dialysis modality on post-transplant outcomes is not clear. This study examined associations of pretransplant dialysis modality with post-transplant outcomes in a large national cohort of kidney transplant recipients.Design, setting, participants, & measurements Linking the 5-year patient data of a large dialysis organization to the Scientific Registry of Transplant Recipients, 12,416 hemodialysis and 2092 peritoneal dialysis patients who underwent first kidney transplantation were identified. Mortality or graft failure and delayed graft function risks were estimated by Cox regression (hazard ratio) and logistic regression (odds ratio), respectively.Results Recipients treated with peritoneal dialysis pretransplantation had lower (21.9/1000 patient-years [95% confidence interval: 18.1-26.5]) crude all-cause mortality rate than those recipients treated with hemodialysis (32.8/1000 patient-years [30.8-35.0]). Pretransplant peritoneal dialysis use was associated with 43% lower adjusted all-cause and 66% lower cardiovascular death. Furthermore, pretransplant peritoneal dialysis use was associated with 17% and 36% lower unadjusted death-censored graft failure and delayed graft function risk, respectively. However, after additional adjustment for relevant covariates, pretransplant peritoneal dialysis modality was not a significant predictor of death-censored graft failure delayed graft function, respectively. Similar trends were noted on analyses using a propensity score matched cohort of 2092 pairs of patients. ConclusionsCompared with hemodialysis, patients treated with peritoneal dialysis before transplantation had lower mortality but similar graft loss or delayed graft function. Confounding by residual selection bias cannot be ruled out.

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“…Beginning with HD instead of PD has been shown to be related to a faster decline of residual renal function during the fi rst year. [35][36][37][38][39][40] In one study, HD patients experienced more hypotensive episodes due to the intermittent character of this modality in comparison with PD. It can be hypothesized that these episodes have resulted in an accelerated decline of residual renal function in HD patients.…”

Section: Peritoneal Dialysis Versus In-center Hemodialysismentioning

confidence: 99%

Home dialysis: A Dutch perspective

Boeschoten

Michels

2011

Dialysis & Transplantation

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For patients with end‐stage renal disease who are not (yet) eligible for renal transplantation, treatment with dialy‐sis is mandatory for survival. Home dialysis modalities (home hemodialysis or peritoneal dialysis) offer patients more ﬂexibility compared with in‐center treatment and have been advocated as the ﬁrst choice in clinically stable patients. However, despite encouraging developments in dialysis systems that make the procedure easier, in many countries the proportion of patients using home dialysis, especially peritoneal dialysis, is decreasing. In Europe this decrease is most pronounced in the Netherlands and the United Kingdom. This evolution cannot be motivated by an inferiority of home dialysis modalities compared with in‐center treatment, as all these modalities have been shown to generate similar results. Other, often non‐medical, factors (such as reimbursement, social and logistic issues, and the experience of physicians and nurses with home dialysis) seem to be responsible for this development.

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Effect of cause and time of dropout on the residual GFR: A comparative analysis of the decline of GFR on dialysis

Cited by 135 publications

References 17 publications

Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes

Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes

Dialysis Modality and Outcomes in Kidney Transplant Recipients

Home dialysis: A Dutch perspective

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