Quality of Life in Automated and Continuous Ambulatory Peritoneal Dialysis

Michels, Wieneke M.; Dijk, S. van; Verduijn, Marion; Cessie, Saskia le; Boeschoten, Elisabeth W.; Dekker, Friedo W.; Krediet, Raymond T.

doi:10.3747/pdi.2010.00063

Cited by 33 publications

(22 citation statements)

References 19 publications

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“…Third, information about dialysis adequacy or additional dialysis modalities such as hemodiafiltration or automated PD was not collected in our study. However, previous studies did not show significant differences between automated PD and continuous ambulatory PD, or between hemodiafiltration and HD [38–42]. Dialysis adequacy also influences clinical outcomes.…”

Section: Discussionmentioning

confidence: 96%

Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients

et al. 2017

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BackgroundHealth-related quality of life (HRQoL) surveys are needed to evaluate regional and ethnic specificies. The aim of the present study was to evaluate the differences in HRQoL, frailty, and disability according to dialysis modality in the Korean population.Patients and methodsWe enrolled relatively stable maintenance dialysis patients. A total of 1,616 patients were recruited into our study. The demographic and laboratory data collected at enrollment included age, sex, comorbidities, frailty, disability, and HRQoL scales.ResultsA total of 1,250 and 366 participants underwent hemodialysis (HD) and peritoneal dialysis (PD), respectively. The numbers of participants with pre-frailty and frailty were 578 (46.2%) and 422 (33.8%) in HD patients, and 165 (45.1%) and 137 (37.4%) in PD patients, respectively (P = 0.349). Participants with a disability included 195 (15.6%) HD patients and 109 (29.8%) PD patients (P < 0.001). On multivariate analysis, the mean physical component scale (PCS) and mental component scale (MCS), symptom/problems, and sleep scores were higher in HD patients than in PD patients. Cox regression analyses showed that an increased PCS in both HD and PD patients was positively associated with patient survival and first hospitalization–free survival. An increased MCS in both HD and PD patients was positively associated with first hospitalization–free survival only.ConclusionThere was no significant difference in frailty between patients treated with the two dialysis modalities; however, disability was more common in PD patients than in HD patients. The MCS and PCS were more favorable in HD patients than in PD patients. Symptom/problems, sleep, quality of social interaction, and social support were more favorable in HD patients than in PD patients; however, patient satisfaction and dialysis staff encouragement were more favorable in PD patients than in HD patients.

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Section: Discussionmentioning

confidence: 96%

Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients

et al. 2017

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“…Such temporal change is not only related to formal clinical indications (e.g. high transporters) but also to a common belief, although not confirmed in some studies, of a better quality of life (15)(16)(17).…”

Section: Discussionmentioning

confidence: 96%

Characterization of the Brazpd ii Cohort and Description of Trends in Peritoneal Dialysis Outcome across Time Periods

et al. 2014

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Observational studies from different regions of the world provide valuable information in patient selection, clinical practice, and their relationship to patient and technique outcome. The present study is the first large cohort providing patient characteristics, clinical practice, patterns and their relationship to outcomes in Latin America. The objective of the present study was to characterize the cohort and to describe the main determinants of patient and technique survival, including trends over time of peritoneal dialysis (PD) initiation and treatment. This was a nationwide cohort study in which all incident adult patients on PD from 122 centers were studied. Patient demographics, socioeconomic and laboratory values were followed from December 2004 to January 2011 and, for comparison purposes, divided into 3 groups according to the year of starting PD: 2005/06, 2007/08 and 2009/10. Patient survival and technique failure (TF) were analyzed using the competing risk model of Fine and Gray. All patients active at the end of follow-up were treated as censored. In contrast, all patients who dropped the study for any reason different from the primary event of interest were treated as competing risk. Significance was set to a p level of 0.05. A total of 9,905 patients comprised the adult database, 7,007 were incident and 5,707 remained at least 90 days in PD. The main cause of dropout was death (54%) and of TF was peritonitis (63%). Technique survival at 1, 2, 3, 4, and 5 years was 91%, 84%, 77%, 68%, and 58%, respectively. There was no change in TF during the study period but 3 independent risk factors were identified: lower center experience, lower age, and automated PD (APD) as initial therapy. Cardiovascular disease (36%) was the main cause of death and the overall patient survival was 85%, 74%, 64%, 54%, and 48% at 1, 2, 3, 4, and 5 years, respectively. Patient survival improved along all study periods: compared to 2005/2006, patients starting at 2007/2008 had a relative risk reduction (SHR) of 0.83 (95% confidence interval [CI] 0.72 - 0.95); and starting in 2009/2010 of 0.69 (95% CI 0.57 - 0.83). The independent risk factors for mortality were diabetes, age > 65 years, previous hemodialysis, starting PD modality, white race, low body mass index (BMI), low educational level, center experience, length of pre-dialysis care, and the year of starting PD. We observed an improvement in patient survival along the years. This finding was sustained even after correction for several confounders and using a competing risk approach. On the other hand, no changes in technique survival were found.

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“…This is a matter of concern as CAPD and APD treatments are complementary in terms of quality of life [28,[41][42][43]; also, they are both offered to assisted PD patients. The fact that nurse-assisted PD is associated with a lower risk of transfer to HD must be considered when assistance modality is presented to end-stage renal disease patients, and should be reconsidered during the course of PD.…”

Section: Discussionmentioning

confidence: 99%

Impact of Assisted Peritoneal Dialysis Modality on Outcomes: A Cohort Study of the French Language Peritoneal Dialysis Registry

et al. 2018

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Background: Patients on peritoneal dialysis (PD) can be assisted by a nurse or a family member and treated either by automated PD (APD) or continuous ambulatory PD (CAPD). The aim of this study was to evaluate the effect of PD modality and type of assistance on the risk of transfer to haemodialysis (HD) and on the peritonitis risk in assisted PD patients. Method: This was a retrospective study based on data from the French Language PD Registry. All adults starting assisted PD in France between 2006 and 2015 were included. Events of interest were transfer to HD, peritonitis and death. Cox regression models were used for statistical analysis. Results: Among the 12,144 incident patients who started PD in France during the study period, 6,167 were assisted. There were 5,060 nurse-assisted and 1,095 family-assisted PD patients. Overall, 5,171 were treated by CAPD and 996 by APD. In multivariate analysis, CAPD, compared to APD, was not associated with the risk of transfer to HD (cause specific hazard ratios [cs-HR] 0.96 [95% CI 0.84–1.09]). Patients on nurse-assisted PD had a lower risk of transfer to HD than family assisted PD patients (cs-HR 0.85 [95% CI 0.75–0.97]). Neither PD modality nor type of assistance were associated with peritonitis risk. Conclusions: In assisted PD, technique survival was not associated with PD modality. Nurse-assisted patients had a lower risk of transfer to HD than family assisted patients. Peritonitis risk was not influenced either by PD modality, or by type of assistance. Both APD and CAPD should be offered to assisted-PD patients.

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Quality of Life in Automated and Continuous Ambulatory Peritoneal Dialysis

Cited by 33 publications

References 19 publications

Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients

Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients

Characterization of the Brazpd ii Cohort and Description of Trends in Peritoneal Dialysis Outcome across Time Periods

Impact of Assisted Peritoneal Dialysis Modality on Outcomes: A Cohort Study of the French Language Peritoneal Dialysis Registry

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