Examination of survival after transfer from peritoneal dialysis to hemodialysis.

Examination of survival after transfer from peritoneal dialysis to hemodialysis. Adv Perit Dial. 2012;28:64-7 Authors: Piraino B, Wyman AE, Sheth H Abstract Data on survival after transfer from peritoneal dialysis (PD) to hemodialysis (HD) is conflicting. We reviewed two decades of outcomes in a PD program to examine short-term survival after transfer from PD to HD. Of 379 patients on PD, 33% transferred to HD. The reasons for transfer were PD-related infections (340%), uremia or failure to thrive (26%), PD catheter problems or loss of mechanical skills (15%), dementia or unable to train (7%), noncompliant with PD (7%), other (10%, including gastrointestinal complications, hernia, encapsulating peritoneal sclerosis, preference, loss of ultrafiltration), and cardiac (2%). All of those transferring for "other" reasons survived 6 months, and as did all except 1 who transferred for uremia (p = 0.035). Overall survival was 92% at 3 months and 85% at 6 months. Using multivariate logistic regression analysis, only score on the Charlson comorbidity index at PD start was a risk factor for dying in the first 6 months on HD: for each 1 point increase in CCI score, the hazard ratio for death was 1.4 (95% confidence interval: 1.16 to 1.74; p = 0.005). To summarize, starting a patient on PD and waiting until uremia to transfer to HD does not have a negative impact on survival. In a program with relatively low PD-related infectious complications, s...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research