The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2015: a summary

Kramer, Anneke; Pippias, Maria; Noordzij, Marlies; Stel, Vianda S.; Afentakis, Nikolaos; Ambühl, Patrice M.; Andrusev, Anton; Fuster, Emma Arcos; Monzón, Federico E Arribas; Åsberg, Anders; Barbullushi, Myftar; Bonthuis, Marjolein; Caskey, Fergus; Nuez, Pablo Castro de la; Čerņevskis, Harijs; Grottes, Jean-Marin des; Gârneaţă, Liliana; Golan, Eliezer; Hemmelder, Marc H; Ioannou, Kyriakos; Jarraya, F.; Kolesnyk, М.; Komissarov, Kirill; Lassalle, Mathilde; Macário, Fernando; Mahillo-Duran, Beatriz; Francisco, A.L.M. de; Pálsson, Runólfur; Pechter, Ülle; Resić, Halima; Rutkowski, Bolesław; Pablos, Carmen Santiuste de; Seyahi, Nurhan; Ogrizovic, Sanja Simic; Roblero, María Fernanda Slon; Spustová, Viera; Stojceva-Taneva, Olivera; Traynor, Jamie P.; Massy, Ziad A.; Jager, Kitty J.

doi:10.1093/ckj/sfx149

Cited by 187 publications

(159 citation statements)

References 2 publications

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“…5,10,34,35, Importantly, not all of the literature reported on whether an early survival benefit was present, or had available data for extraction. 41,[43][44][45]50,52,54,57,62,63,65,70,72,76 Such studies were excluded from the analysis. Also, an early survival benefit was sought but not found in a smaller number of studies and patients.…”

Section: Introductionmentioning

confidence: 99%

The benefit of early survival on PD versus HD—Why this is (still) very important

Marshall

2020

Perit Dial Int

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There are a number of misconceptions around the identified early survival benefit of peritoneal dialysis (PD) relative to hemodialysis (HD), including that such benefits "even out in the end" since the relative risk of death over time eventually encompasses 1.0 (or even an estimate that is unfavorable to PD); that the early benefit is, in fact, most likely due to unmeasured confounding; and such benefits are only due to the influence of central venous catheters and "crash starters" in the HD group. In fact, the early survival benefit results in a substantial gain of patient life years in PD cohorts relative to HD ones, even if it the benefit appears to "even out in the end," is relatively insensitive to unmeasured confounding, and persists even when the effects of central venous catheters are accounted for. In this review, the calculations and arguments are made to support these tenets. Survival on dialysis is still one of the most important considerations for all stakeholders in the end-stage kidney disease community, including patients who rank it among their top priorities. Shared decision-making is a fundamental patient right and requires both balanced information and an iterative mechanism for a consensual decision based on shared understanding and purpose. A cornerstone of this process should be an explicit discussion of the early survival benefit of PD relative to HD.Why early, beneficial hazard ratios do not "even out in the end" if the hazard ratio subsequently encompasses 1.0In medical research, comparing the relative risk of death between two treatments involves the calculation of a ratio: a rate ratio, an odds ratio, or a hazard ratio (HR) depending on the type of statistical test used for the computation. A Poisson model compares the frequency (rate ratio), a

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Section: Introductionmentioning

confidence: 99%

The benefit of early survival on PD versus HD—Why this is (still) very important

Marshall

2020

Perit Dial Int

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“…Diabetes has become the most common cause of end-stage renal disease (ESRD) treated by renal replacement therapy (RRT) in most countries around the world; it accounts for 45%, 23%, and 44% of incident cases of RRT requirement in North America [1], Europe [2], and Japan [3], respectively.…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 196,000 patients worldwide underwent PD in 2008, representing 11% of the dialysis population [5]. However, diabetic patients were less likely than nondiabetic patients to receive PD as first RRT in North America (9.0% vs. 10.1%, respectively) [1], Europe (14% vs. 15%, respectively) [2], and Japan (4.9% vs. 6.6%, respectively) [3]. Possible reasons for this therapeutic preference include anxiety regarding worsening of glycemic control, higher prevalence of PD-associated peritonitis, overhydration and rapid RRF decline due to proteinuria and inflammation, and technical problems due to visual disorders and peripheral neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of peritoneal dialysis and hemodialysis as first renal replacement therapy in patients with end-stage renal disease and diabetes: a systematic review

Maruyama

Higuchi

et al. 2019

Ren Replace Ther

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Background: Diabetes has become the most common cause of end-stage renal disease (ESRD) requiring renal replacement therapy (RRT) in most countries around the world. Peritoneal dialysis (PD) is valuable for patients newly requiring RRT because of the preservation of residual renal function (RRF), higher quality of life, and hemodynamic stability in comparison with hemodialysis (HD). A previous systematic review produced conflicting results regarding patient survival. As several advances have been made in therapy for diabetic patients receiving PD, we conducted a systematic review of studies published after 2014 to determine whether incident PD or HD is advantageous for the survival of patients with diabetes. Methods: For this systematic review, the MEDLINE, EMBASE, and CENTRAL databases were searched to identify articles published between February 2014 and August 2017. The quality of studies was assessed using the GRADE approach. Outcomes of interest were all-cause mortality; RRF; major morbid events, including cardiovascular disease (CVD) and infectious disease; and glycemic control. This review was performed using a predefined protocol published in PROSPERO (CRD42018104258). Results: Sixteen studies were included in this review. All were retrospective observational studies, and the risk of bias, especially failure to adequately control confounding factors, was high. Among them, 15 studies investigated allcause mortality in diabetic patients initiating PD and HD. Differences favoring HD were observed in nine studies, whereas those favoring PD were observed in two studies. Two studies investigated effects on CVD, and both demonstrated the superiority of incident HD. No study investigated the effect of any other outcome. Conclusions: In the present systematic review, the risk of death tended to be higher among diabetic patients with ESRD newly initiating RRT with incident PD in comparison with incident HD. However, we could not obtain definitive results reflecting the superiority of PD or HD with regard to patient outcomes because of the severe risk of bias and the heterogeneity of management strategies for diabetic patients receiving dialysis. Further studies are needed to clarify the advantages of PD and HD as RRT for diabetic patients with ESRD.

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“…One-and fiveyear survival probabilities among incident dialysis patients in the United States are only slightly lower than corresponding probabilities in Canada and throughout the European Union [32]. However, several process outcomes could be addressed.…”

Section: Resultsmentioning

confidence: 99%

Contemporary Trends in Clinical Outcomes among Dialysis Patients with Medicare Coverage

Weinhandl

Ray²,

Kubisiak³

et al. 2019

Am J Nephrol

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Background: The dialysis patient population in the United States continues to grow. Trends in rates of death and hospitalization among dialysis patients have important consequences for outpatient dialysis capacity and Medicare spending. Objectives: To estimate contemporary trends in rates of death and hospitalization among dialysis patients in the United States, overall and within subgroups. Methods: We used Medicare Limited Data Sets (100% sample) in 2014–2017 to estimate trends in rates of death and hospitalization among dialysis patients with Medicare Parts A and B enrollment. We used seasonal autoregressive integrated moving average models to identify secular trends in the incidence of outcomes. Results: There were 631,075 unique patients; 222,924 deaths; and 1,876,779 hospital admissions. Weekly risks of both death and hospitalization exhibited strong seasonality. However, overall weekly risks of death were 34.9, 35.4, 35.2, and 35.7 deaths per 10,000 patients in 2014–2017, respectively (p = 0.47, from a likelihood ratio test of secular trend). The overall weekly risk of hospitalization was 3.08, 3.05, 3.11, and 3.11% in 2014, 2015, 2016, and 2017, respectively (p = 0.30). There were significant secular trends in risk of death in subgroups defined by black race and residency in South Atlantic states (p < 0.05). There were also secular trends in risk of hospitalization in subgroups defined by age 20–44 years, concurrent enrollment in Medicaid, and residency in South Central states. Conclusion: For the first time since the beginning of this century, rates of both death and hospitalization among dialysis patients with Medicare fee-for-service coverage have stagnated. The reasons for this change are unknown and require detailed assessment. Persistent lack of change in clinical outcomes may alter the future expectations about dialysis patient population growth.

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The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2015: a summary

Cited by 187 publications

References 2 publications

The benefit of early survival on PD versus HD—Why this is (still) very important

The benefit of early survival on PD versus HD—Why this is (still) very important

Comparison of peritoneal dialysis and hemodialysis as first renal replacement therapy in patients with end-stage renal disease and diabetes: a systematic review

Contemporary Trends in Clinical Outcomes among Dialysis Patients with Medicare Coverage

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