Document Detail


Timely transfer of peritoneal dialysis patients to hemodialysis improves survival rates.
MedLine Citation:
PMID:  16429841     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The two main renal replacement therapies (RRT)--hemodialysis (HD) and peritoneal dialysis (PD)--have been considered to be antagonistic in most published studies on the clinical outcomes of dialysis patients. Recently, it has been suggested that the complementary use of both modalities as an integrated care (IC) strategy might improve the survival rate of end-stage renal disease patients. The aim of this study was to estimate the final clinical outcome of PD patients when they transfer to HD because of complications related to PD. MATERIALS AND METHODS: We retrospectively analyzed data from the following patients that started RRT during the last 10 years: 33 PD patients (IC group; age 55 +/- 15 years, mean +/- SD) who transferred to HD, 134 PD patients (PD group, age 64 +/- 11 years) who remained in PD, and 132 HD patients (HD group, age 48 +/- 16 years) who started and continued in HD. The main reasons for the transfer to HD were relapsed peritonitis and loss of ultrafiltration, while various comorbid risk factors were adjusted by Cox hazards regression model (age, presence of diabetes or/and cardiovascular disease, serum hemoglobin and albumin levels, as well as the modality per se). RESULTS: 3- and 5-year survival rates for the IC, PD and HD groups were 97% and 81%, 54% and 28%, and 92% and 83%, respectively. The 5-year survival rate was significantly higher in IC patients than in PD patients (p < 0.00001) but, was not different from that in HD patients. CONCLUSIONS: Our results show that the IC of dialysis patients undergoing RRT improves the survival of patients on PD if they are transferred to HD upon the appearance of PD related complications.
Authors:
S Panagoutsos; K Kantartzi; P Passadakis; E Yannatos; E Mourvati; M Theodoridis; P Kriki; E Thodis; V Vargemezis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  65     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-24     Completed Date:  2006-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  43-7     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Democritus University of Thrace, Alexandroupolis, Greece.
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Kidney Failure, Chronic / mortality*
Male
Middle Aged
Patient Transfer*
Peritoneal Dialysis* / adverse effects,  mortality
Proportional Hazards Models
Renal Dialysis* / mortality
Retrospective Studies
Survival Rate

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


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