Renal replacement therapy in Canada: A report from the Canadian Organ replacement register

Vesicoureteral Reflux

“…Approximately 5% to 7% of people entering end-stage kidney failure programs have reflux nephropathy nominated as the primary cause. [83][84][85][86][87][88] This is rarely a biopsy diagnosis but generally a clinical diagnosis based upon past history of renal tract imaging appearances. 89 -91 Factors other than VUR must be on the causal pathway to produce sufficient kidney damage to result in kidney failure.…”

Comparing Mortality of Elderly Patients on Hemodialysis versus Peritoneal Dialysis

“…(1-22) These studies vary enormously with regard to population selection criteria, sample size, statistical methodology, definition of treatment, and availability of information on important potential confounders. The various results are conflicting: some studies have found a survival benefit for PD patients (12,16,18,20), others for those on HD (10,11,13), and still others have found mortality not to differ (2)(3)(4)(5)(6)(7)(8)14,15,19,21,22).Many of these previous studies, and all studies on US populations after 1983 have not adequately addressed a key methodologic issue: assessments that start at 4 or 6 mo after onset of RRT are likely to discard relevant events that occur between the first dialysis treatment and the chosen starting point of such studies, particularly modality switches and deaths. This omission can result in biased estimates of effect.…”

A Potential Role of Peritoneal Dialysis as ‘a Bridging Therapy’ to Other Renal Replacement Therapies

“…As a result, comparison of survival between the two forms of dialysis over the last decade has produced controversial results. There have been significant discrepancies regarding survival on HD and PD, with some authors reporting no difference between the two therapies [3], others reporting better outcomes in HD [4, 5, 6]and yet others documenting improved survival with PD [7, 8, 9]. This controversy also holds true in the comparison of hospitalization between these two therapies, with some authors reporting increased hospitalization in patients on PD [10, 11, 12, 13]; however, this has not been confirmed by others [14, 15].…”