Skip to main content
Log in

Patient outcome in primary peritoneal dialysis patients versus those transferred from hemodialysis and transplantation

  • Nephrology – Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Background

According to the concept of integrated care, renal transplantation, peritoneal dialysis (PD), and hemodialysis (HD) should be considered three complementary methods of renal replacement therapy. This study tried to evaluate patient outcomes in three different groups of PD patients, namely primary PD patients, those transferred to PD with failing kidney transplant, and those transferred to PD from HD.

Method

From January 1, 1995, to end of 2006 from 26 PD centers, 1,355 patients including demographic, clinical and laboratory data, which were monthly collected through questionnaires, were enrolled in the study. We compared patients’ characteristics, factors affecting patient survival, and patient outcomes between primary PD patients (group 1, n = 1,067), patients transferred from transplantation (group 2, n = 43) and those transferred from HD (group 3, n = 245), which had been on HD for at least 3 months before switching to PD.

Results

There was no difference in the proportion of patients with diabetes in the three groups. Overall, 238 patients (17.5%) were transferred to HD but there was no significant difference in PD technique survival on between the three groups. Death occurred in 256 (24%), 3 (7%) and 65 (26.5%) subjects in groups 1, 2 and 3, respectively. Most patients (81.5%) in group 2 underwent re-transplantation. The Kaplan–Meier survival rates were not different between the three groups. In the Cox multiple regression model, age, presence of diabetes and serum albumin level significantly influenced patient survival.

Conclusion

We concluded that PD could be considered safe for patients experiencing complications on HD, as well as for those with renal transplantation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Van Biesen W, Vanholder R, Lameier N (2000) The role of peritoneal dialysis as the first-line renal replacement modality. Perit Dial Int 20:375–383

    PubMed  Google Scholar 

  2. Thodis E, Passadakis P, Vargemezis V, Oreopoulos DG (2001) Peritoneal dialysis: better than, equal to, or worse than hemodialysis? Data worth knowing before choosing a dialysis modality. Perit Dial Int 21:25–35

    PubMed  CAS  Google Scholar 

  3. Mendelssohn DC, Pierratos A (2002) Reformulating the integrated care concept for the new millennium. Perit Dial Int 22:5–8

    PubMed  Google Scholar 

  4. Oreopoulos DG, Thodis E, Passadakis P, Vargemezis V (2009) Home dialysis as a first option: a new paradigm. Int Urol Nephrol 41(3):595–605

    Article  PubMed  Google Scholar 

  5. Mendelssohn DC (2009) Increasing pd utilization: should suitable patients be forced? Perit Dial Int 29(2):144–146

    PubMed  Google Scholar 

  6. Benaroia M, Mendelssohn DC (2010) The home dialysis first paradigm: suitability and transitioning. Int Urol Nephrol 42:715–717

    Article  PubMed  Google Scholar 

  7. Simmons RG, Abress L (1990) Quality-of-life issues for end-stage renal disease patients. Am J Kidney Dis 15:201–208

    PubMed  CAS  Google Scholar 

  8. Eggers P (1992) Comparison of treatment costs between dialysis and transplantation. Semin Nephrol 12:284–289

    PubMed  CAS  Google Scholar 

  9. Guo A, Mujais S (2003) Patient and technique survival on peritoneal dialysis in the united states: evaluation in large incident cohorts. Kidney Int Suppl 88:S3–S12

    Article  PubMed  Google Scholar 

  10. Maiorca R, Vonesh EF, Cavalli P et al (1991) A multicenter, selection-adjusted comparison of patients and technique survivals on CAPD and hemodialysis. Perit Dial Int 11:118–127

    PubMed  CAS  Google Scholar 

  11. Lupo A, Tarchini R, Carcarini G et al (1994) Long-term outcome in continuous ambulatory peritoneal dialysis: a 10-year-survey by the Italian Cooperative Peritoneal Dialysis Study Group. Am J Kid Dis 24:826–837

    PubMed  CAS  Google Scholar 

  12. Davies SJ, Phillips L, Griffiths AM et al (1998) What really happens to people on long-term peritoneal dialysis? Kidney Int 54:2207–2217

    Article  PubMed  CAS  Google Scholar 

  13. Van Biesen W, Vanholder RC, Veys N et al (2000) An evaluation of an integrative care approach for end-stage renal disease patients. J Am Soc Nephrol 11:116–125

    PubMed  Google Scholar 

  14. Heaf JG, Lokkegaard H, Madsen M (2002) Initial survival advantage of peritoneal dialysis relative to haemodialysis. Nephrol Dial Transplant 17:112–117

    Article  PubMed  Google Scholar 

  15. Sipahioglu MH, Aybal A, Ünal A et al (2008) Patient and technique survival and factors affecting mortality on peritoneal dialysis in Turkey: 12 years’ experience in a single center. Perit Dial Int 28:238–245

    PubMed  CAS  Google Scholar 

  16. Shinzato T, Nakai S, Akiba T et al (1999) Report of the annual statistical survey of the Japanese society for dialysis therapy in 1996. Kidney Int 55:700–712

    Article  PubMed  CAS  Google Scholar 

  17. Han SH, Lee JE, Kim DK et al (2008) Long-term clinical outcomes of peritoneal dialysis patients: single center experience from Korea. Perit Dial Int 28(S3):S21–S26

    PubMed  Google Scholar 

  18. Collins AJ, Kasiske B, Herzog C et al (2007) Excerpts from the United States renal data system 2006 annual data report. Am J Kidney Dis 49(1 Suppl 1):A6–A7 S1–S296

    Article  PubMed  Google Scholar 

  19. Verger C, Ryckelynck JP, Duman M et al (2006) French peritoneal dialysis registry (RDPLF): outline and main results. Kidney Int Suppl 103:S12–S20

    Article  PubMed  Google Scholar 

  20. Chung SH, Noh H, Jeon JS et al (2009) Impact of incremental risk factors on peritoneal dialysis patient survival: proposal of a simplified clinical mortality risk score. Blood Purif 27:165–171

    Article  PubMed  Google Scholar 

  21. Liberek T, Renke M, Skonieczny B et al (2009) Therapy outcome in peritoneal dialysis patients transferred from haemodialysis. Nephrol Dial Transplant 24:2889–2894

    Article  PubMed  Google Scholar 

  22. Schaubel DE, Fenton SS (2000) Trends in mortality on peritoneal dialysis: Canada, 1981–1997. J Am Soc Nephrol 11:126–133

    PubMed  CAS  Google Scholar 

  23. Jager KJ, Merkus MP, Dekker FW et al (1999) Mortality and technique failure in patients starting chronic peritoneal dialysis: results of The Netherlands cooperative study on the adequacy of dialysis. NECOSAD study group. Kidney Int 55:1476–1485

    Article  PubMed  CAS  Google Scholar 

  24. Collins AJ, Hao W, Xia H et al (1999) Mortality risks of peritoneal dialysis and hemodialysis. Am J Kidney Dis 34:1065–1074

    Article  PubMed  CAS  Google Scholar 

  25. Fenton SS, Schaubel DE, Desmeules M et al (1997) Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates. Am J Kidney Dis 30:334–342

    Article  PubMed  CAS  Google Scholar 

  26. Selgas R, Cirugeda A, Fernandez-Perpen A et al (2001) Comparisons of hemodialysis and CAPD in patients over 65 years of age: A meta-analysis. Int Urol Nephrol 33:259–264

    Article  PubMed  CAS  Google Scholar 

  27. Zhang X, Han F, He Q et al (2008) Outcomes and risk factors for mortality after transfer from hemodialysis to peritoneal dialysis in uremic patients. Perit Dial Int 28:313–314

    PubMed  CAS  Google Scholar 

  28. Lobbedez T, Crand A, Le Roy F et al (2005) Transfer from chronic hemodialysis to peritoneal dialysis. Nephrol Ther 1:38–43

    PubMed  Google Scholar 

  29. Davies SJ (2001) Peritoneal dialysis in the patient with a failing renal allograft. Perit Dial Int 21:S280–S284

    PubMed  Google Scholar 

  30. Van Biesen W, Dequidt C, Vijt D et al (1998) Analysis of the reasons for transfers between hemodialysis and peritoneal dialysis and their effect on survivals. Adv Perit Dial 14:90–94

    PubMed  Google Scholar 

  31. Maiorca R, Cancarini GC, Brunori G et al (1996) Comparison of long-term survival between hemodialysis and peritoneal dialysis. Adv Perrit Dial 12:79–88

    CAS  Google Scholar 

  32. Szeto CC, Wong TY, Chow KM et al (2001) Impact of dialysis adequacy on the mortality and morbidity of anuric Chinese patients receiving continuous ambulatory peritoneal dialysis. J Am Soc Nephrol 12:355–360

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tayebeh Soleymanian.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Najafi, I., Hosseini, M., Atabac, S. et al. Patient outcome in primary peritoneal dialysis patients versus those transferred from hemodialysis and transplantation. Int Urol Nephrol 44, 1237–1242 (2012). https://doi.org/10.1007/s11255-011-0068-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-011-0068-x

Keywords

Navigation