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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

Survival curves regarding the incidence of a first episode of hospitalization among the patients with polycystic kidney disease on peritoneal dialysis and hemodialysis.
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f3: Survival curves regarding the incidence of a first episode of hospitalization among the patients with polycystic kidney disease on peritoneal dialysis and hemodialysis.

Mentions: Around 70% of the patients with PCKD on dialysis experienced at least one hospitalization during the follow-up period (Table 3). The patients on PD had around 35% higher risk for the first episode of hospitalization (Fig. 3). However, after taking repeated hospitalizations into consideration, the rates of hospitalization were not significantly different between the patients undergoing PD and HD based on intention to treat analysis (Table 3). The number of hospitalizations with intensive care unit stay, length of hospital stay, and in-hospital mortality rate were similar between the patients on PD and HD. The patients on PD had a higher rate of infection-related hospitalizations(58.2% vs. 44.7%, pā€‰=ā€‰0.02, based on intention to treat analysis).


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)

Survival curves regarding the incidence of a first episode of hospitalization among the patients with polycystic kidney disease on peritoneal dialysis and hemodialysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3: Survival curves regarding the incidence of a first episode of hospitalization among the patients with polycystic kidney disease on peritoneal dialysis and hemodialysis.
Mentions: Around 70% of the patients with PCKD on dialysis experienced at least one hospitalization during the follow-up period (Table 3). The patients on PD had around 35% higher risk for the first episode of hospitalization (Fig. 3). However, after taking repeated hospitalizations into consideration, the rates of hospitalization were not significantly different between the patients undergoing PD and HD based on intention to treat analysis (Table 3). The number of hospitalizations with intensive care unit stay, length of hospital stay, and in-hospital mortality rate were similar between the patients on PD and HD. The patients on PD had a higher rate of infection-related hospitalizations(58.2% vs. 44.7%, pā€‰=ā€‰0.02, based on intention to treat analysis).

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