Trends in assisted peritoneal dialysis over the last decade: a cohort study from the French Peritoneal Dialysis Registry

Boyer, Annabel; Lanot, Antoine; Lambie, Mark; Guillouët, Sonia; Lobbedez, Thierry; Béchade, Clémence

doi:10.1093/ckj/sfaa051

Cited by 19 publications

(16 citation statements)

References 37 publications

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“…The worsening over time of transfers to HD due to catheter issues in family-assisted PD patients could reflect a decrease in caregivers’ involvement. A preceding study by our team found a linear decline in family-assisted PD use over time, notably among others, because of a modification in the state of caregivers’ health [48]. Catheter complications, a leading cause of early PD cessation [8, 14, 44], have been acknowledged as an important consideration by patients and healthcare professionals [33].…”

Section: Discussionmentioning

confidence: 99%

Trends in Peritoneal Dialysis Technique Survival, Death, and Transfer to Hemodialysis: A Decade of Data from the RDPLF

et al. 2021

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Introduction: There is limited information on the trends of peritoneal dialysis (PD) technique survival over time. This study aimed to estimate the effect of calendar time on technique survival, transfer to hemodialysis (HD) (and the individual causes of transfer), and patient survival. Methods: This retrospective, multicenter study, based on data from the French Language Peritoneal Dialysis Registry, analyzed 14,673 patients who initiated PD in France between January 1, 2005, and December 31, 2016. Adjusted Cox regressions with robust variance were used to examine the probability of a composite end point of either death or transfer to HD, death, and transfer to HD, accounting for the nonlinear impact of PD start time. Results: There were 10,201 (69.5%) cases of PD cessation over the study period: 5,495 (37.4%) deaths and 4,706 (32.1%) transfers to HD. The rate of PD cessation due to death or transfer to HD decreased over time (PR 0.96, 95% CI: 0.95–0.97). Compared to 2009–2010, starting PD between 2005 and 2008 or 2011 and 2016 was strongly associated with a lower rate of transfer to HD (PR 0.88, 95% CI: 0.81–0.96, and PR 0.91, 95% CI: 0.84–0.99, respectively), mostly due to a decline in the rate of infection-related transfers to HD (PR 0.96, 95% CI: 0.94–0.98). Conclusions: Rates of the composite end point of either death or transfer to HD, death, and transfer to HD have decreased in recent decades. The decline in transfers to HD rates, observed since 2011, is mainly the result of a significant decline in infection-related transfers.

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Section: Discussionmentioning

confidence: 99%

Trends in Peritoneal Dialysis Technique Survival, Death, and Transfer to Hemodialysis: A Decade of Data from the RDPLF

et al. 2021

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“…Une descriptiion du fontionnement du RDPLF a été publiée il y a quelques années [1], et différents travaux portant sur les modules optionnels ont été publié récemments [2][3][4][5][6][7][8][9] aux quels nous rennvoyons le lecteur. Le but de cet article est de faire une synthèse des résultats bruts observés dans le module principal en 2020 et de susciter, à partir de là, de futurs travaux plus élaborés.…”

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Home dialysis in french speaking countries in 2020 (RDPLF database)

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et al. 2021

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The RDPLF collects the main peritoneal dialysis data from centers in French-speaking countires and, since 2012, home hemodialysis (HHD) data. This article presents a summary of the main results in the RDPLF in 2020. It highlights important differences in the practices and patient profiles between French-speaking countries. Mortality in patients with clinical symptoms of COVID-19 varied from 15 to 63% depending on the country. A slight drop in the incidence rate for peritoneal dialysis in 2020 was observed when the Covid-19 pandemic should have favored a dialysis treatment at home. In patients with HHD, daily hemodialysis five days a week, at a low flow rate of dialysate, is predominant in the new centers and sometimes begins to appear as a mode of transition which allows to maintain at home patients who cannot anymore be treated by PD. In HHD, the use of a central catheter is frequent in Belgium while this is exceptional in France. Likewise, in France, puncture of an arteriovenous fistula remains classic, while in Belgium the Buttonhole technique is widely preferred. We did not observe COVID-19 mortality in HHD in 2020 but only 47% of HDD patients are included in the RDPLF while 98% of PD patients are included.

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“…29,30 Additionally, in the coming ageing society, nurses' role in assisted PD will be of much more importance. 31 The present study has several limitations that need to be acknowledged. First, due to the retrospective observational design of this study and the causality between the submission rate and patients' clinical outcomes, we could not know whether the increase in the submission rate leads to improvement in patients' clinical outcomes.…”

Section: Discussionmentioning

confidence: 90%

“…Training based on principles of adult education and the experience of PD nurses are aspects of a successful PD programme 29,30 . Additionally, in the coming ageing society, nurses' role in assisted PD will be of much more importance 31 …”

Section: Discussionmentioning

confidence: 99%

Self‐assessment sheet submission rate predicts technique survival in patients initiating peritoneal dialysis

et al. 2022

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Aim: Patients play a crucial role in preventing peritoneal dialysis (PD)-related events, including peritonitis and fluid overload, as PD procedures are mainly carried out at home. We asked patients to submit a PD self-assessment sheet at each outpatient visit in our daily clinical practice and evaluated its usefulness for outcomes in patients initiating PD.Methods: This retrospective cohort study included patients who underwent PD catheter insertion between January 2008 and October 2018. The submission rate of a PD self-assessment sheet was calculated from medical records until PD cessation or study completion (October 2020). The association between the submission rate and technique survival was analysed.Results: Among the 105 recruited patients (78 men, 60.4 ± 12.2 years), 44 discontinued PD and transferred to haemodialysis during the study period. The follow-up was 52.3 (28.7-79.3) months, and the median submission rate was 78%. The log-rank test showed that technique survival was significantly better in patients with a submission rate ≥ 78% than those with a submission rate <78% (p = .006). The submission rate remained significantly associated with less technique failure (hazard ratio 0.88 per 10%, p = .002) by the Cox regression analysis adjusted for age, sex, Charlson comorbidity index, estimated glomerular filtration rate and geriatric nutritional risk index. Conclusion:The submission rate of a PD self-assessment sheet is useful as a predictor of technique survival in patients initiating PD. Instruction that increases submission may improve technique survival in PD patients.

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Trends in assisted peritoneal dialysis over the last decade: a cohort study from the French Peritoneal Dialysis Registry

Cited by 19 publications

References 37 publications

Trends in Peritoneal Dialysis Technique Survival, Death, and Transfer to Hemodialysis: A Decade of Data from the RDPLF

Trends in Peritoneal Dialysis Technique Survival, Death, and Transfer to Hemodialysis: A Decade of Data from the RDPLF

Home dialysis in french speaking countries in 2020 (RDPLF database)

Self‐assessment sheet submission rate predicts technique survival in patients initiating peritoneal dialysis

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