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Comparative Study of Outcomes among Patients with Polycystic Kidney Disease on Hemodialysis and Peritoneal Dialysis.

Yang JY, Chen L, Chao CT, Peng YS, Chiang CK, Kao TW, Chien KL, Wu HY, Huang JW, Hung KY - Sci Rep (2015)

Bottom Line: We compared the risks for death, hospitalization and medical expenditures between the patients on PD and propensity-score matched patients on hemodialysis (HD).The overall survival did not differ between the patients on PD and HD.Although the patients on PD had a higher risk for hospitalization, the medical expenditure for PD was 10% lower.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

ABSTRACT
Polycystic kidney disease (PCKD) is the most common hereditary cause of end-stage renal disease, the complications of which may prevent the choice of peritoneal dialysis (PD). The aim of this study was to explore the effects of dialysis modality on outcomes in patients with PCKD. We extracted a cohort of 1417 adult patients with PCKD initiating long-term dialysis therapy in 1999-2010 from the Taiwan National Health Insurance Research Database, among which 125 patients chose PD. The patients on HD were older and had a higher comorbidity index compared to those on PD. We compared the risks for death, hospitalization and medical expenditures between the patients on PD and propensity-score matched patients on hemodialysis (HD). The overall survival did not differ between the patients on PD and HD. The patients on PD tended to have higher hazard ratios (HR) for the first episode of hospitalization (adjusted HR 1.34 [95% CI, 1.04-1.79]). The annual medical expenses were 10% lower for the patients on PD. PD is an equivalent choice of renal replacement therapy to HD for patients with PCKD in terms of survival. Although the patients on PD had a higher risk for hospitalization, the medical expenditure for PD was 10% lower.

No MeSH data available.


Related in: MedlinePlus

Flowchart of patient selection.
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f1: Flowchart of patient selection.

Mentions: The patient selection flowchart is shown in Fig. 1. The prevalence of PCKD among the patients with ESRD in Taiwan is around 1.9%. We identified1417 patients with PCKD who initiated long-term dialysis during 1999–2010, among whom125 (8.8%) received PD. The patients on HD were older and had a higher comorbidity index compared to the patients on PD (Table 1). The median follow-up period was 3.6 years. The 1- and 5-year mortality rates after ESRD among the patients with PCKD were 8.1% and 25.2%,respectively. There was an increasing trend regarding the incident age of ESRD(mean age 55.0 in 1999 and 59.5 in 2010; p value for trend: 0.01) and the percentage of patients choosing PD as the dialysis modality among the patients with PCKD (4.2% in 1999 and 10.4% in 2010, p value for trend: 0.02)during 1999 to 2010.


Comparative Study of Outcomes among Patients with Polycystic Kidney Disease on Hemodialysis and Peritoneal Dialysis.

Yang JY, Chen L, Chao CT, Peng YS, Chiang CK, Kao TW, Chien KL, Wu HY, Huang JW, Hung KY - Sci Rep (2015)

Flowchart of patient selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526846&req=5

f1: Flowchart of patient selection.
Mentions: The patient selection flowchart is shown in Fig. 1. The prevalence of PCKD among the patients with ESRD in Taiwan is around 1.9%. We identified1417 patients with PCKD who initiated long-term dialysis during 1999–2010, among whom125 (8.8%) received PD. The patients on HD were older and had a higher comorbidity index compared to the patients on PD (Table 1). The median follow-up period was 3.6 years. The 1- and 5-year mortality rates after ESRD among the patients with PCKD were 8.1% and 25.2%,respectively. There was an increasing trend regarding the incident age of ESRD(mean age 55.0 in 1999 and 59.5 in 2010; p value for trend: 0.01) and the percentage of patients choosing PD as the dialysis modality among the patients with PCKD (4.2% in 1999 and 10.4% in 2010, p value for trend: 0.02)during 1999 to 2010.

Bottom Line: We compared the risks for death, hospitalization and medical expenditures between the patients on PD and propensity-score matched patients on hemodialysis (HD).The overall survival did not differ between the patients on PD and HD.Although the patients on PD had a higher risk for hospitalization, the medical expenditure for PD was 10% lower.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

ABSTRACT
Polycystic kidney disease (PCKD) is the most common hereditary cause of end-stage renal disease, the complications of which may prevent the choice of peritoneal dialysis (PD). The aim of this study was to explore the effects of dialysis modality on outcomes in patients with PCKD. We extracted a cohort of 1417 adult patients with PCKD initiating long-term dialysis therapy in 1999-2010 from the Taiwan National Health Insurance Research Database, among which 125 patients chose PD. The patients on HD were older and had a higher comorbidity index compared to those on PD. We compared the risks for death, hospitalization and medical expenditures between the patients on PD and propensity-score matched patients on hemodialysis (HD). The overall survival did not differ between the patients on PD and HD. The patients on PD tended to have higher hazard ratios (HR) for the first episode of hospitalization (adjusted HR 1.34 [95% CI, 1.04-1.79]). The annual medical expenses were 10% lower for the patients on PD. PD is an equivalent choice of renal replacement therapy to HD for patients with PCKD in terms of survival. Although the patients on PD had a higher risk for hospitalization, the medical expenditure for PD was 10% lower.

No MeSH data available.


Related in: MedlinePlus