Impact of peritoneal dialysis strategy on technique and patient survival.
chronic renal insufficiency
icodextrin
peritoneal dialysis
peritonitis
survival analysis
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
15
01
2023
medline:
4
12
2023
pubmed:
4
12
2023
entrez:
4
12
2023
Statut:
epublish
Résumé
The aim of this study was to evaluate the impact of peritoneal dialysis (PD) strategy on technique and patient survival. This was a retrospective, single-center study conducted on consecutive patients with chronic kidney disease who underwent PD between January 2009 and December 2019. The study sample was stratified into four different groups according to PD technique [automated (APD) or manual (CAPD)] and icodextrin use (yes versus no). The primary endpoints were survival of both technique and patient. A total of 531 patients were included in the analysis. Mean ± standard deviation age was 60.6 ± 14.6 years, 68.4% (363) were men and 34.8% (185) had diabetes. The median technique survival time was 19 (15) months. A total of 185 (34.8%), 96 (18.1%), 99 (18.7%) and 151 (28.4%) patients were included in the CAPD/No-Icodextrin, CAPD/Icodextrin, APD/No-Icodextrin and APD/Icodextrin study groups, respectively. Throughout the study, 180 (33.9%) patients underwent renal transplant, 71 (13.4%) were changed to hemodialysis and 151 (28.4%) died. Age [hazard ratio (HR) 0.975, 95% confidence interval (CI) 0.960-0.990, Icodextrin use and APD/Icodextrin had a positive impact on patient survival, while older age and higher Charlson Index had a negative one. Age and incidence of early peritoneal infection significantly impacted on technique survival.
Sections du résumé
Background
UNASSIGNED
The aim of this study was to evaluate the impact of peritoneal dialysis (PD) strategy on technique and patient survival.
Methods
UNASSIGNED
This was a retrospective, single-center study conducted on consecutive patients with chronic kidney disease who underwent PD between January 2009 and December 2019. The study sample was stratified into four different groups according to PD technique [automated (APD) or manual (CAPD)] and icodextrin use (yes versus no). The primary endpoints were survival of both technique and patient.
Results
UNASSIGNED
A total of 531 patients were included in the analysis. Mean ± standard deviation age was 60.6 ± 14.6 years, 68.4% (363) were men and 34.8% (185) had diabetes. The median technique survival time was 19 (15) months. A total of 185 (34.8%), 96 (18.1%), 99 (18.7%) and 151 (28.4%) patients were included in the CAPD/No-Icodextrin, CAPD/Icodextrin, APD/No-Icodextrin and APD/Icodextrin study groups, respectively. Throughout the study, 180 (33.9%) patients underwent renal transplant, 71 (13.4%) were changed to hemodialysis and 151 (28.4%) died. Age [hazard ratio (HR) 0.975, 95% confidence interval (CI) 0.960-0.990,
Conclusions
UNASSIGNED
Icodextrin use and APD/Icodextrin had a positive impact on patient survival, while older age and higher Charlson Index had a negative one. Age and incidence of early peritoneal infection significantly impacted on technique survival.
Identifiants
pubmed: 38046044
doi: 10.1093/ckj/sfad155
pii: sfad155
pmc: PMC10689157
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2523-2529Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.
Déclaration de conflit d'intérêts
All the co-authors have no conflict of interest to declare.
Références
Nephrol Dial Transplant. 2011 May;26(5):1702-8
pubmed: 20921296
Int Urol Nephrol. 2016 Jul;48(7):1177-85
pubmed: 27115159
Nephrol Dial Transplant. 2010 Jun;25(6):1973-9
pubmed: 20097847
Am J Kidney Dis. 2014 Jun;63(6):1027-37
pubmed: 24423779
Arch Intern Med. 2011 Jan 24;171(2):110-8
pubmed: 20876398
Medicine (Baltimore). 2016 Mar;95(13):e2991
pubmed: 27043667
Perit Dial Int. 2019 May-Jun;39(3):252-260
pubmed: 30852520
Kidney Int Suppl. 2008 Apr;(108):S76-80
pubmed: 18379553
Nephrol Dial Transplant. 2012 May;27(5):2044-50
pubmed: 21968011
J Am Soc Nephrol. 2004 Jan;15(1):174-9
pubmed: 14694170
JAMA. 2004 Feb 11;291(6):697-703
pubmed: 14871912
Perit Dial Int. 2011 May-Jun;31(3):301-7
pubmed: 21282373
Cochrane Database Syst Rev. 2018 Oct 26;10:CD007554
pubmed: 30362116
Contrib Nephrol. 2006;150:254-258
pubmed: 16721018
Perit Dial Int. 2018 Dec;38(Suppl 2):S25-S35
pubmed: 30315042
J Am Soc Nephrol. 2003 Nov;14(11):2851-60
pubmed: 14569095
Perit Dial Int. 2001 Jan-Feb;21(1):52-7
pubmed: 11280496
PLoS One. 2015 Jul 27;10(7):e0134047
pubmed: 26214801
Perit Dial Int. 2011 Mar-Apr;31(2):179-88
pubmed: 21119069
Nephrology (Carlton). 2015 Mar;20(3):161-7
pubmed: 25487756
Kidney Int. 2001 Feb;59(2):754-63
pubmed: 11168959
Kidney Int. 2008 Feb;73(4):480-8
pubmed: 18046315
Am J Kidney Dis. 2018 Mar;71(3):344-351
pubmed: 29174322
Am J Kidney Dis. 2020 Jun;75(6):830-846
pubmed: 32033860