Variation in Peritoneal Dialysis Time on Therapy by Country: Results from the Peritoneal Dialysis Outcomes and...

Area of Science:

• Nephrology
• Public Health
• Epidemiology

Background:

• Accurate quantification of time on peritoneal dialysis (PD) is crucial for patient and provider management.
• Understanding PD duration in relation to outcomes like hemodialysis transfer, mortality, and kidney transplantation is essential.

Purpose of the Study:

• To analyze the duration of peritoneal dialysis therapy across diverse international settings.
• To investigate patient and facility factors associated with outcomes such as transfer to hemodialysis and death.

Main Methods:

• Utilized data from the multinational, observational Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) conducted between 2014 and 2017.
• Calculated cumulative incidence of PD to hemodialysis transfer, death, or kidney transplantation over 5 years for 7121 patients across 218 facilities.
• Performed adjusted analyses for patient and facility factors influencing death and hemodialysis transfer.

Main Results:

• Median time on PD varied significantly by country, ranging from 1.7 years (UK) to 3.2 years (Japan).
• Higher kidney transplantation rates correlated with shorter PD duration.
• Infection was the primary cause for hemodialysis transfer, with higher risks observed in patients with psychiatric history or elevated BMI.

Conclusions:

• International variations in PD duration are linked to kidney transplantation rates.
• Identifying infection as a major driver for hemodialysis transfer, alongside specific patient and facility factors, can guide interventions to reduce adverse events and optimize PD therapy.