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Hemodialysis versus peritoneal dialysis

Marta Rigoni, Emanuele Torri, Giandomenico Nollo, Diana Zarantonello, Alessandro Laudon, Laura Sottini, Giovanni Maria Guarrera, Giuliano Brunori
AIMS: Despite several studies reporting similar outcomes for peritoneal dialysis (PD) and hemodialysis (HD), the former is underused worldwide, with a PD prevalence of 15% in Italy. In 2008, the Unit of Nephrology and Dialysis of the Healthcare Trust of the Autonomous Province of Trento implemented a successful PD program which has increased the proportion of PD incident patients from 7 to 47%. We aimed to assess the effect of this extensive use of PD by comparing HD and PD in terms of survival and time-to-transplantation...
November 29, 2016: Journal of Nephrology
Sunita Bavanandan, Ghazali Ahmad, Ai-Hong Teo, Lilian Chen, Frank Xiaoqing Liu
OBJECTIVES: To investigate the 5-year health care budget impact of variable distribution of adult patients treated with peritoneal dialysis (PD) and in-center hemodialysis (ICHD) on government funding in Malaysia. METHODS: An Excel-based budget impact model was constructed to assess dialysis-associated costs when changing dialysis modalities between PD and ICHD. The model incorporates the current modality distribution and accounts for Malaysian government dialysis payments and erythropoiesis-stimulating agent costs...
May 2016: Value in Health Regional Issues
Wan-Ning Wang, Wen-Long Zhang, Tao Sun, Fu-Zhe Ma, Sensen Su, Zhong-Gao Xu
The aim of this meta-analysis was to evaluate the effect of peritoneal dialysis (PD) and hemodialysis (HD) on renal anemia (RA) in renal disease patients by a meta-analysis. Relevant studies published before June 2015 were searched. Pooled odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the effect of HD and PD on RA based on five indexes: hemoglobin, ferritin, transferrin saturation index, serum albumin, and parathyroid hormone. Sensitivity analysis and publication bias assessment were conducted to evaluate the stability and reliability of our results...
November 17, 2016: Renal Failure
V Filiopoulos, D Biblaki, L Takouli, A Dounavis, D Hadjiyannakos, D Vlassopoulos
Peritoneal dialysis (PD) is limited mainly by a higher technique failure rate as compared to hemodialysis (HD), catheter malfunction being an important reason. Intra- and extra-peritoneal catheter configuration may be associated with mechanical and infectious complications affecting method survival. We report our experience with two extra-peritoneal catheter configurations: the straight and the swan-neck (SN) catheters. A total of 85 consecutive patients, 58 males and 27 females were included in the study. Among them, 26 were diabetics; 52 were treated with automated PD (APD) and 33 with continuous ambulatory PD (CAPD)...
September 2016: Indian Journal of Nephrology
Hao Yan, Wei Fang, Aiwu Lin, Liou Cao, Zhaohui Ni, Jiaqi Qian
BACKGROUND: Incident patients treated with continuous ambulatory peritoneal dialysis (CAPD) are often prescribed either 3 or 4 exchanges per day. However, the effects on residual kidney function and clinical outcomes of 3 versus 4 exchanges are not known. STUDY DESIGN: Prospective, randomized, controlled, open-label study. SETTING & PARTICIPANTS: Incident CAPD patients aged 18 to 80 years with glomerular filtration rates (GFRs; mean of renal urea and creatinine clearance from a 24-hour urine collection) ≥ 2mL/min and urine volume ≥ 500mL/d...
October 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Eric L Wallace, Janice Lea, Ninad Chaudhary, Russell Griffin, Eric Hammelman, Joshua Cohen, James A Sloand
♦ Background: United States Renal Data System (USRDS) data from 2014 show that African Americans (AA) are underrepresented in the home dialysis population, with 6.4% versus 9.2% utilization in the general populace. This racial disparity may be inaccurately ascribed to the nation as a whole if regional and inter-state variability exists. This investigation sought to examine home dialysis utilization by minority Medicare beneficiary populations across the US nationally, regionally, and by individual state. ♦ Methods: The 2012 Medicare 100% Outpatient Standard Analytic File was used to identify all Medicare fee-for-service (FFS) patients, with state of residence and race, receiving an outpatient dialysis facility bill type...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Timmy Lee, Mae Thamer, Yi Zhang, Qian Zhang, Michael Allon
BACKGROUND AND OBJECTIVES: Few studies have evaluated vascular access use after transition from peritoneal dialysis to hemodialysis. Our study characterizes vascular access use after switch to hemodialysis and its effect on patient mortality and evaluates whether a peritonitis event preceding the switch was associated with the timing of permanent vascular access placement and use. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The US Renal Data System data were used to evaluate the establishment of a permanent vascular access in 1165 incident Medicare-insured adult patients on dialysis who initiated peritoneal dialysis between July 1, 2010 and June 30, 2011 and switched to hemodialysis within 1 year...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Keren Ladin, Naomi Lin, Emily Hahn, Gregory Zhang, Susan Koch-Weser, Daniel E Weiner
BACKGROUND: Although shared decision-making (SDM) can better align patient preferences with treatment, barriers remain incompletely understood and the impact on patient satisfaction is unknown. METHODS: This is a qualitative study with semistructured interviews. A purposive sample of prevalent dialysis patients ≥65 years of age at two facilities in Greater Boston were selected for diversity in time from initiation, race, modality and vintage. A codebook was developed and interrater reliability was 89%...
August 30, 2016: Nephrology, Dialysis, Transplantation
I-Kuan Wang, Kuo-Hung Lin, Shih-Yi Lin, Cheng-Li Lin, Chiz-Tzung Chang, Tzung-Hai Yen, Fung-Chang Sung
BACKGROUND: Studies investigating the risk of cardiac dysrhythmia warranting permanent pacemaker therapy for end-stage renal disease (ESRD) patients are limited. This study investigated the incidence rate of permanent cardiac pacing in dialysis patients. METHODS: Using the Taiwan National Health Insurance Database, we identified 28 471 newly diagnosed ESRD patients in 2000-2010 [9700 on peritoneal dialysis (PD) and 18 771 on hemodialysis (HD)] and 113 769 randomly selected controls without kidney disease, frequency-matched by sex, age and diagnosis date...
August 18, 2016: Nephrology, Dialysis, Transplantation
Yu-Tzu Chang, Jing-Shiang Hwang, Shih-Yuan Hung, Min-Sung Tsai, Jia-Ling Wu, Junne-Ming Sung, Jung-Der Wang
Although treatment for the dialysis population is resource intensive, a cost-effectiveness analysis comparing hemodialysis (HD) and peritoneal dialysis (PD) by matched pairs is still lacking. After matching for clinical characteristics and propensity scores, we identified 4,285 pairs of incident HD and PD patients from a Taiwanese national cohort during 1998-2010. Survival and healthcare expenditure were calculated by data of 14-year follow-up and subsequently extrapolated to lifetime estimates under the assumption of constant excess hazard...
2016: Scientific Reports
I-Kuan Wang, Te-Chun Shen, Chih-Hsin Muo, Tzung-Hai Yen, Fung-Chang Sung
BACKGROUND: This study compared the pulmonary embolism (PE) risks between Asian dialysis patients and a comparison cohort without clinical kidney disease. METHODS: From the National Health Insurance claims data of Taiwan, we identified 106 231 newly diagnosed end-stage renal disease patients undergoing dialysis in 1998-2010 and randomly selected 106 231 comparison subjects, frequency matched by age, sex and the index year. We further selected 7430 peritoneal dialysis (PD) patients and 7340 propensity score-matched hemodialysis (HD) patients...
July 22, 2016: Nephrology, Dialysis, Transplantation
Nevin İlhan, Kadir Ateş, Necip İlhan, Dilara Kaman, Hüseyin Çeliker
BACKGROUND: Chronic kidney diseases are known to influence nitric oxide metabolites (NOx) and asymmetric dimethylarginine (ADMA), though the exact mechanism is still poorly understood. AIMS: The purpose of the present study was to examine eNOS Glu298Asp gene polymorphism, plasma NOx and ADMA concentration in subjects with and without End-stage Renal Disease. STUDY DESIGN: Case-control study. METHODS: In this study, genotype distributions of Glu-298Asp in exon 7 of the eNOS gene polymorphisms in 130 hemodialysis and 64 peritoneal dialysis patients were compared with 92 controls...
March 2016: Balkan Medical Journal
Silvia Brand Silva, Heitor Mansur Caulliraux, Claudia Affonso Silva Araújo, Eduardo Rocha
This study aimed to compare the direct medical costs of renal transplantation and renal replacement therapies, specifically hemodialysis and peritoneal dialysis, from the perspective of the Brazilian Unified National Health System (SUS). Renal replacement therapies costs were based on data published in the literature. Cost items for kidney transplant were identified in a private hospital based on procedure codes used for charging the SUS, and other items were taken from the literature. In the four years covered by the study, cadaver kidney transplant generated per-patient savings of BRL 37,000 and BRL 74,000 compared to hemodialysis and peritoneal dialysis, respectively...
June 1, 2016: Cadernos de Saúde Pública
Teresa Dipalma, Mario Fernández-Ruiz, Manuel Praga, Natalia Polanco, Esther González, Elena Gutiérrez-Solis, Eduardo Gutiérrez, Amado Andrés
Previous studies have reported contradictory results regarding the effect of pre-transplant dialysis modality on the outcomes after kidney transplantation (KT). To minimize the confounding effect of donor-related variables, we performed a donor-matched retrospective comparison of 160 patients that received only one modality of pre-transplant dialysis (peritoneal dialysis [PD] and hemodialysis [HD] in 80 patients each) and that subsequently underwent KT at our center between January 1990 and December 2007. Cox regression models were used to evaluate the association between pre-transplant dialysis modality and primary study outcomes (death-censored graft survival and patient survival)...
September 2016: Clinical Transplantation
I-Kuan Wang, Chi-Yu Lu, Cheng-Li Lin, Chih-Chia Liang, Tzung-Hai Yen, Yao-Lung Liu, Fung-Chang Sung
BACKGROUND: The purpose of the study was to compare the risk of de novo cardiovascular disease (CVD) between hemodialysis (HD) and peritoneal dialysis (PD) in patients with incident end-stage renal disease (ESRD). METHODS: From a Taiwanese universal insurance claims database, we identified 45309 incident ESRD patients without preexisting CVD from 2000 to 2010. Using the propensity score matching method, we included 6516 patients in HD and PD groups, respectively...
September 1, 2016: International Journal of Cardiology
Sunna Snaedal, Abdul R Qureshi, Sigrún H Lund, Guna Germanis, Britta Hylander, Olof Heimbürger, Juan J Carrero, Peter Stenvinkel, Peter Bárány
BACKGROUND: Inflammation is a common feature in dialysis patients and is associated with cardiovascular complications and poor outcome. Measuring the variability of inflammatory markers may help in understanding underlying factors triggering inflammation. Whether the inflammatory pattern in hemodialysis (HD) and peritoneal dialysis (PD) patients differs has scarcely been studied. Here we explored factors associated with the magnitude and variability of inflammation markers in HD and PD patients...
August 2016: Nephrology, Dialysis, Transplantation
S Bavanandan, G Ahmad, A H Teo, L Chen, F X Liu
No abstract text is available yet for this article.
November 2014: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Biswanath Basu, Tapan Kumar Sinha Mahapatra, Birendranath Roy, Franz Schaefer
BACKGROUND: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with high patient morbidity and mortality. There is no consensus on the best RRT modality for pediatric AKI. METHODS: The efficacy and safety of continuous peritoneal dialysis (cPD) and daily intermittent hemodialysis (dHD) were compared in 136 children aged 1 month to 16 years requiring RRT for AKI. Mortality, risk factors and causes of death, 1-month and 3-month renal recovery rates, and technique-related complications were assessed...
October 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Hiroki Kobayashi, Masanori Abe, Yoshinori Yoshida, Hiroko Suzuki, Noriaki Maruyama, Kazuyoshi Okada
Compared with glycated hemoglobin (HbA1c), glycated albumin (GA) is superior in estimating glycemic control in diabetic patients on hemodialysis (HD). However, the better index for assessment of glycemic control in diabetic patients on peritoneal dialysis (PD) and the impact of protein loss on GA are unknown. Twenty diabetic patients on HD were matched by age, sex, and baseline postprandial plasma glucose (PG) levels to 20 PD patients. PG, HbA1c, GA, and serum albumin levels were measured for six months. Protein loss in PD patients was estimated by measuring the protein concentration in the peritoneal dialysate and by 24 h urine collection...
2016: International Journal of Molecular Sciences
Virginia Wang, Matthew L Maciejewski, Cynthia J Coffman, Linda L Sanders, Shoou-Yih Daniel Lee, Richard Hirth, Joseph Messana
OBJECTIVE: To examine the relationship between distance to dialysis provider and patient selection of dialysis modality, informed by the absolute distance from a patient's home and relative distance of alternative modalities. DATA SOURCES: U.S. Renal Data System. STUDY DESIGN: About 70,131 patients initiating chronic dialysis and 4,795 dialysis facilities in 2006. The primary outcome was patient utilization of peritoneal dialysis (PD). Independent variables included absolute distance between patients' home and the nearest hemodialysis (HD) facility, relative distance between patients' home and nearest PD versus nearest HD facilities, and their interaction...
April 7, 2016: Health Services Research
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