| Changes in patient and technique survival over time among incident peritoneal dialysis patients in Canada. | |
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MedLine Citation:
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PMID: 22554718 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: In the last 15 years in Canada, there have been less stringent guidelines for peritoneal dialysis (PD) adequacy, availability of novel PD solutions, and lower PD-related peritonitis rates. Effects of these changes on outcomes of incident patients treated with PD during this period are unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Risk of PD technique failure and mortality were compared among three incident cohorts of PD patients who initiated dialysis during the following periods: 1995-2000, 2001-2005, and 2006-2009. A multivariable model was used to evaluate time to PD technique failure using inverse probability of treatment and censoring weights accounting for changing survival and transplantation rates. RESULTS: Between 1995 and 2009,13,120 incident adult PD patients were identified from the Canadian Organ Replacement Register. Compared with the 1995-2000 cohort (n=5183), the risk of PD technique failure was lower among patients between 2001 and 2005 (n=4316) but similar among incident patients between 2006 and 2009 (n=3621). Cause-specific PD technique failure revealed no difference in PD peritonitis-related technique failure over time. PD technique failure due to inadequate PD was initially higher in the 2001-2005 cohort but lower in the 2006-2009 cohort compared with the 1995-2000 cohort. Relative to incident patients between 1995 and 2000, adjusted mortality was lower among incident patients between 2001 and 2005 and 2006 and 2009. CONCLUSIONS: Survival on PD continues to improve with only modest changes in PD technique failure. Peritonitis remains an ongoing and modifiable source of PD technique failure. |
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Authors:
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Jeffrey Perl; Ron Wald; Joanne M Bargman; Yingbo Na; S Vanita Jassal; Arsh K Jain; Louise Moist; Sharon J Nessim |
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Publication Detail:
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Type: Journal Article Date: 2012-05-03 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 7 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-07-09 Completed Date: 2012-11-13 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1145-54 Citation Subset: IM |
Affiliation:
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Division of Nephrology, University of Toronto, Ontario, Canada. jeff.perl@utoronto.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Canada Female Humans Kidney Failure, Chronic / mortality*, therapy* Male Middle Aged Peritoneal Dialysis / methods*, trends* Prospective Studies Survival Rate Time Factors Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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