Abstract
Introduction: Transition to hemodialysis (HD) is a common outcome in peritoneal dialysis (PD), but the associated mortality risk is poorly understood. This study sought to identify rates of and risk factors for mortality after transitioning from PD to HD. Methods: Patients with incident PD (between 2000 and 2014) who transferred to HD for ≥1 day were identified, using data from Australia and New Zealand Dialysis and Transplantation registry (ANZDATA), Canadian Organ Replacement Register (CORR), Europe Renal Association (ERA) Registry, and the United States Renal Dialysis System (USRDS). Crude mortality rates were calculated for the first 180 days after transfer. Separate multivariable Cox models were built for early (<90 days), medium (90–180 days), and late (>180 days) periods after transfer. Results: Overall, 6683, 5847, 21,574, and 80,459 patients were included from ANZDATA, CORR, ERA Registry, and USRDS, respectively. In all registries, crude mortality rate was highest during the first 30 days after a transfer to HD declining thereafter to nadir at 4 to 6 months. Crude mortality rates were lower for patients transferring in the most recent years (than earlier). Older age, PD initiation in earlier cohorts, and longer PD vintage were associated with increased risk of death, with the strongest associations during the first 90 days after transfer and attenuating thereafter. Mortality risk was lower for men than women <90 days after transfer, but higher after 180 days. Conclusion: In this multinational study, mortality was highest in the first month after a transfer from PD to HD and risk factors varied by time period after transfer. This study highlights the vulnerability of patients at the time of modality transfer and the need to improve transitions.
| Original language | English |
|---|---|
| Pages (from-to) | 1062-1073 |
| Number of pages | 12 |
| Journal | Kidney International Reports |
| Volume | 7 |
| Issue number | 5 |
| Early online date | 2022 |
| DOIs | |
| Publication status | Published - May 2022 |
Keywords
- hemodialysis
- peritoneal dialysis
- survival
- technique failure
- transition
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In: Kidney International Reports, Vol. 7, No. 5, 05.2022, p. 1062-1073.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Mortality Trends After Transfer From Peritoneal Dialysis to Hemodialysis
AU - Nadeau-Fredette, Annie-Claire
AU - Sukul, Nidhi
AU - Lambie, Mark
AU - Perl, Jeffrey
AU - Davies, Simon
AU - Johnson, David W.
AU - Robinson, Bruce
AU - van Biesen, Wim
AU - Kramer, Anneke
AU - Jager, Kitty J.
AU - Saran, Rajiv
AU - Pisoni, Ronald
AU - Chan, Christopher T.
AU - INTEGRATED Study Group
AU - Combes, Gill
AU - Firanek, Catherine
AU - Gomez, Rafael
AU - Jha George, Vivek
AU - Madero, Magdalena
AU - Masakane, Ikuto
AU - Misra, Madhukar
AU - McDonald, Stephen
AU - Mitra, Sandip
AU - Moraes, Thyago
AU - Mukhopadhyay, Puma
AU - Sloand, James
AU - Tong, Allison
AU - Szeto, Cheuk-Chun
N1 - Funding Information: ACNF has a junior 1 scholarship from Fonds de Recherche du Québec - Santé and a previous research grant from Baxter Healthcare. ML has received honoraria from Fresenius Medical Care, Baxter Healthcare, and NxStage and a research grant from Baxter Healthcare. DWJ has received consultancy fees, research grants, speaker’s honoraria and travel sponsorships from Baxter Healthcare and Fresenius Medical Care, consultancy fees from Astra Zeneca and AWAK, speaker’s honoraria and travel sponsorships from ONO, and travel sponsorships from Amgen. He is a current recipient of an Australian National Health and Medical Research Council Practitioner Fellowship. WVB has received speaker fees and travel funds from Fresenius Medical Care and Baxter. BR has received consultancy fees or travel reimbursement in the last 3 years from AstraZeneca, GlaxoSmithKline, and Kyowa Kirin Co. all paid directly to his institution of employment. SD has received grant funding from Baxter HealthCare and Fresenius Medica Care and advisory board fees from Baxter HealthCare and Ellen Medical. All the other authors declared no competing interests. Funding Information: This study was supported by a Baxter Health Care Extramural Grant. We acknowledge the contribution of the following “INTEGRATED research initiative” additional members: Gill Combes, Catherine Firanek, Rafael Gomez, Vivek Jha George, Magdalena Madero, Ikuto Masakane, Madhukar Misra, Stephen McDonald, Sandip Mitra, Thyago Moraes, Puma Mukhopadhyay, James Sloand, Allison Tong, and Cheuk-Chun Szeto. For the ANZDATA: The authors gratefully acknowledge the substantial contribution of the entire Australia and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators, and patients) in providing information for and maintaining the ANZDATA registry database. Funding Information: For the CORR: The authors thank the staff at CORR for maintaining the database and the dialysis units throughout Canada for submitting information to CORR. For the ERA Registry: The authors thank the patients and the staff of the dialysis and transplant units for contributing the data via their national and regional renal registries. Furthermore, we gratefully acknowledge the following registries and persons for their contribution of the data: Austrian Dialysis and Transplant Registry (R. Kramar); Dutch speaking Belgian Society of Nephrology (M. Couttenye, F. Schroven, and J. De Meester); French speaking Belgian Society of Nephrology (JM. des Grottes and F. Collart); Danish Nephrology Registry (J.G. Heaf); Finnish Registry for Kidney Diseases (P. Finne, J. Helve and P.H. Groop); Hellenic Renal Registry (G. Moustakas); Icelandic End-Stage Renal Disease Registry (R. Pálsson); Norwegian Renal Registry (A.V. Reisæter and A. Åsberg); Swedish Renal Registry (M. Stendahl, H. Rydell, M. Evans, K.G. Prütz, T. Lundgren, and M. Segelmark); Dutch Renal Registry (L. Heuveling, S. Vogelaar, and M. Hemmelder); UK Renal Registry (all staff of the UK Renal Registry and of the renal units submitting data); Scottish Renal Registry (all of the Scottish renal units); and the regional registries of Andalusia (P. Castro de la Nuez [on behalf of all users of SICATA]), Asturias (P. Beltrán, J.R. Quirós, and RERCA Working Group), Basque country [UNIPAR] (Á. Magaz, J. Aranzabal, M. Rodrigo, and I. Moina), Catalonia [RMRC] (E. Arcos, J. Comas, and J. Tort), and Valencian regions [REMRENAL] (M. Ferrer Alamar, N. Fuster Camarena and J. Pérez Penadés); and A. Kramer and R. Boenink in the AMC Registry office for data collection and management. The ERA Registry is funded by the European Renal Association. This article was written by NAMES of ALL AUTHORS on behalf of the ERA Registry which is an official body of the ERA (European Renal Association). For USRDS: This study was performed under a National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases USRDS Coordinating Center contract HHSN276201400001C. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US government. The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. At the time of this writing, the USRDS Coordinating Center was located at the University of Michigan Kidney Epidemiology and Cost Center, in partnership with Arbor Research Collaborative for Health, Ann Arbor, MI. The USRDS director was Rajiv Saran, MBBS, MD, MRCP, MS, Professor of Medicine and Epidemiology at the University of Michigan, and the co-deputy directors were Vahakn B. Shahinian, MD, MS, Associate Professor of Medicine at the University of Michigan and Bruce M. Robinson, MD, Vice President Clinical Research, Arbor Research Collaborative for Health. The National Institute of Diabetes and Digestive and Kidney Diseases project officers were Kevin C. Abbott, MD, MPH, and Lawrence Y.C. Agodoa, MD. Any views or opinions expressed are solely those of the authors and do not necessarily represent those of the UK Renal Registry. The data reported here have been supplied by the ANZDATA. The interpretation and reporting of these data are the responsibility of the Editors and in no way should be seen as an official policy or interpretation of the Australia and New Zealand Dialysis and Transplant Registry. Funding Information: This study was supported by a Baxter Health Care Extramural Grant. We acknowledge the contribution of the following “INTEGRATED research initiative” additional members: Gill Combes, Catherine Firanek, Rafael Gomez, Vivek Jha George, Magdalena Madero, Ikuto Masakane, Madhukar Misra, Stephen McDonald, Sandip Mitra, Thyago Moraes, Puma Mukhopadhyay, James Sloand, Allison Tong, and Cheuk-Chun Szeto. For the ANZDATA: The authors gratefully acknowledge the substantial contribution of the entire Australia and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators, and patients) in providing information for and maintaining the ANZDATA registry database. For the CORR: The authors thank the staff at CORR for maintaining the database and the dialysis units throughout Canada for submitting information to CORR. For the ERA Registry: The authors thank the patients and the staff of the dialysis and transplant units for contributing the data via their national and regional renal registries. Furthermore, we gratefully acknowledge the following registries and persons for their contribution of the data: Austrian Dialysis and Transplant Registry (R. Kramar); Dutch speaking Belgian Society of Nephrology (M. Couttenye, F. Schroven, and J. De Meester); French speaking Belgian Society of Nephrology (JM. des Grottes and F. Collart); Danish Nephrology Registry (J.G. Heaf); Finnish Registry for Kidney Diseases (P. Finne, J. Helve and P.H. Groop); Hellenic Renal Registry (G. Moustakas); Icelandic End-Stage Renal Disease Registry (R. Pálsson); Norwegian Renal Registry (A.V. Reisæter and A. Åsberg); Swedish Renal Registry (M. Stendahl, H. Rydell, M. Evans, K.G. Prütz, T. Lundgren, and M. Segelmark); Dutch Renal Registry (L. Heuveling, S. Vogelaar, and M. Hemmelder); UK Renal Registry (all staff of the UK Renal Registry and of the renal units submitting data); Scottish Renal Registry (all of the Scottish renal units); and the regional registries of Andalusia (P. Castro de la Nuez [on behalf of all users of SICATA]), Asturias (P. Beltrán, J.R. Quirós, and RERCA Working Group), Basque country [UNIPAR] (Á. Magaz, J. Aranzabal, M. Rodrigo, and I. Moina), Catalonia [RMRC] (E. Arcos, J. Comas, and J. Tort), and Valencian regions [REMRENAL] (M. Ferrer Alamar, N. Fuster Camarena and J. Pérez Penadés); and A. Kramer and R. Boenink in the AMC Registry office for data collection and management. The ERA Registry is funded by the European Renal Association. This article was written by NAMES of ALL AUTHORS on behalf of the ERA Registry which is an official body of the ERA (European Renal Association). For USRDS: This study was performed under a National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases USRDS Coordinating Center contract HHSN276201400001C. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US government. The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. At the time of this writing, the USRDS Coordinating Center was located at the University of Michigan Kidney Epidemiology and Cost Center, in partnership with Arbor Research Collaborative for Health, Ann Arbor, MI. The USRDS director was Rajiv Saran, MBBS, MD, MRCP, MS, Professor of Medicine and Epidemiology at the University of Michigan, and the co-deputy directors were Vahakn B. Shahinian, MD, MS, Associate Professor of Medicine at the University of Michigan and Bruce M. Robinson, MD, Vice President Clinical Research, Arbor Research Collaborative for Health. The National Institute of Diabetes and Digestive and Kidney Diseases project officers were Kevin C. Abbott, MD, MPH, and Lawrence Y.C. Agodoa, MD. Any views or opinions expressed are solely those of the authors and do not necessarily represent those of the UK Renal Registry. The data reported here have been supplied by the ANZDATA. The interpretation and reporting of these data are the responsibility of the Editors and in no way should be seen as an official policy or interpretation of the Australia and New Zealand Dialysis and Transplant Registry. Publisher Copyright: © 2022 International Society of Nephrology
PY - 2022/5
Y1 - 2022/5
N2 - Introduction: Transition to hemodialysis (HD) is a common outcome in peritoneal dialysis (PD), but the associated mortality risk is poorly understood. This study sought to identify rates of and risk factors for mortality after transitioning from PD to HD. Methods: Patients with incident PD (between 2000 and 2014) who transferred to HD for ≥1 day were identified, using data from Australia and New Zealand Dialysis and Transplantation registry (ANZDATA), Canadian Organ Replacement Register (CORR), Europe Renal Association (ERA) Registry, and the United States Renal Dialysis System (USRDS). Crude mortality rates were calculated for the first 180 days after transfer. Separate multivariable Cox models were built for early (<90 days), medium (90–180 days), and late (>180 days) periods after transfer. Results: Overall, 6683, 5847, 21,574, and 80,459 patients were included from ANZDATA, CORR, ERA Registry, and USRDS, respectively. In all registries, crude mortality rate was highest during the first 30 days after a transfer to HD declining thereafter to nadir at 4 to 6 months. Crude mortality rates were lower for patients transferring in the most recent years (than earlier). Older age, PD initiation in earlier cohorts, and longer PD vintage were associated with increased risk of death, with the strongest associations during the first 90 days after transfer and attenuating thereafter. Mortality risk was lower for men than women <90 days after transfer, but higher after 180 days. Conclusion: In this multinational study, mortality was highest in the first month after a transfer from PD to HD and risk factors varied by time period after transfer. This study highlights the vulnerability of patients at the time of modality transfer and the need to improve transitions.
AB - Introduction: Transition to hemodialysis (HD) is a common outcome in peritoneal dialysis (PD), but the associated mortality risk is poorly understood. This study sought to identify rates of and risk factors for mortality after transitioning from PD to HD. Methods: Patients with incident PD (between 2000 and 2014) who transferred to HD for ≥1 day were identified, using data from Australia and New Zealand Dialysis and Transplantation registry (ANZDATA), Canadian Organ Replacement Register (CORR), Europe Renal Association (ERA) Registry, and the United States Renal Dialysis System (USRDS). Crude mortality rates were calculated for the first 180 days after transfer. Separate multivariable Cox models were built for early (<90 days), medium (90–180 days), and late (>180 days) periods after transfer. Results: Overall, 6683, 5847, 21,574, and 80,459 patients were included from ANZDATA, CORR, ERA Registry, and USRDS, respectively. In all registries, crude mortality rate was highest during the first 30 days after a transfer to HD declining thereafter to nadir at 4 to 6 months. Crude mortality rates were lower for patients transferring in the most recent years (than earlier). Older age, PD initiation in earlier cohorts, and longer PD vintage were associated with increased risk of death, with the strongest associations during the first 90 days after transfer and attenuating thereafter. Mortality risk was lower for men than women <90 days after transfer, but higher after 180 days. Conclusion: In this multinational study, mortality was highest in the first month after a transfer from PD to HD and risk factors varied by time period after transfer. This study highlights the vulnerability of patients at the time of modality transfer and the need to improve transitions.
KW - hemodialysis
KW - peritoneal dialysis
KW - survival
KW - technique failure
KW - transition
UR - https://www.scopus.com/pages/publications/85126566855
U2 - 10.1016/j.ekir.2022.02.016
DO - 10.1016/j.ekir.2022.02.016
M3 - Article
C2 - 35570995
SN - 2468-0249
VL - 7
SP - 1062
EP - 1073
JO - Kidney International Reports
JF - Kidney International Reports
IS - 5
ER -