Document Detail


Chronic peritoneal dialysis in the United States: declining utilization despite improving outcomes.
MedLine Citation:
PMID:  17804675     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the United States, chronic peritoneal dialysis take-on has declined among incident ESRD patients. Although increasing age, co-morbidity, and body size may explain part of this decline, other factors likely contribute. Among incident ESRD patients in the United States, we found that peritoneal dialysis take-on significantly decreased from 11% in 1996 to 1997 to 7% in 2002 to 2003 (P < 0.001 for the trend). This decrease remained after adjusting for patient demographics, case-mix, and laboratory data, suggesting the involvement of other factors. This decline in utilization occurred during a time of improving outcomes for incident peritoneal dialysis patients, measured as reduced hazards for death or for the need to transfer to hemodialysis. In contrast, among patients initially treated with hemodialysis, the 12-month adjusted hazards for death or transfer to peritoneal dialysis slightly worsened or were unchanged over this same period. Therefore, the decline in peritoneal dialysis take-on cannot be entirely explained by increasing age, co-morbidity and body size of incident ESRD patients. The decline in utilization has occurred at a time when the early outcomes of CPD patients have improved.
Authors:
Rajnish Mehrotra; Dulcie Kermah; Linda Fried; Kamyar Kalantar-Zadeh; Osman Khawar; Keith Norris; Allen Nissenson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2007-09-05
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  18     ISSN:  1046-6673     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-27     Completed Date:  2008-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2781-8     Citation Subset:  IM    
Affiliation:
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA. rmehrotra@labiomed.org
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Body Size
Comorbidity
Female
Humans
Kidney Failure, Chronic / epidemiology*,  mortality,  therapy
Male
Middle Aged
Peritoneal Dialysis / statistics & numerical data,  utilization*
Treatment Outcome
United States / epidemiology
Grant Support
ID/Acronym/Agency:
MD00148/MD/NCMHD NIH HHS; RR03026/RR/NCRR NIH HHS; RR11145/RR/NCRR NIH HHS; RR14616/RR/NCRR NIH HHS; RR18298/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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