Switching from Peritoneal Dialysis to Hemodialysis: A Study
Author Information
Author(s): Jaar Bernard G, Plantinga Laura C, Crews Deidra C, Fink Nancy E, Hebah Nasser, Coresh Josef, Kliger Alan S, Powe Neil R
Primary Institution: Johns Hopkins University School of Medicine
Hypothesis
What factors and outcomes are associated with switching from peritoneal dialysis to hemodialysis?
Conclusion
Switching from peritoneal dialysis to hemodialysis occurs early and is common, but it does not affect survival rates.
Supporting Evidence
- 24.8% of PD patients switched to HD, with over 70% switching within the first 2 years.
- Infectious peritonitis was the leading cause of switching.
- Black patients and those with higher BMI were more likely to switch from PD to HD.
Takeaway
Some people on peritoneal dialysis have to switch to hemodialysis, especially if they get infections, but it doesn't mean they will live shorter lives.
Methodology
A prospective cohort study of 262 PD patients from 28 clinics across 13 U.S. states, using Cox proportional hazards regression to analyze switching and mortality.
Potential Biases
Potential bias due to loss to follow-up and combining different types of peritoneal dialysis.
Limitations
Limited data on residual urine output and peritoneal membrane characteristics; small sample size; some loss to follow-up.
Participant Demographics
262 patients, primarily white and black, with a mean age of 54.7 years.
Statistical Information
P-Value
0.02 for age difference between switchers and non-switchers
Confidence Interval
RH (95% CI) of 5.01 (1.15–21.8) for black versus white and 1.09 (1.03–1.16) per 1 kg/m2 increase in BMI.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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