Document Detail

Changes in patient and technique survival over time among incident peritoneal dialysis patients in Canada.
MedLine Citation:
PMID:  22554718     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article     Date:  2012-05-03
Journal Detail:
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:
Created Date:  2012-07-09     Completed Date:  2012-11-13     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1145-54     Citation Subset:  IM    
Division of Nephrology, University of Toronto, Ontario, Canada.
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MeSH Terms
Kidney Failure, Chronic / mortality*,  therapy*
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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