Peritoneal dialysis in the US: evaluation of outcomes in contemporary cohorts

Kidney Int Suppl. 2006 Nov;(103):S21-6. doi: 10.1038/sj.ki.5001912.

Abstract

Secular trends in dialysis therapy delivery require a frequent re-examination of outcomes in patients on renal replacement modalities. We examined four large cohorts of patients initiating peritoneal dialysis (PD) in 2000-2003 (total of >40 000 patients) to ascertain trends in patient outcomes, technique success, and predictors of both parameters of interest. Age, end-stage renal disease vintage, and diabetes were clear predictors of patient survival. Technique success was higher in patients on automated PD than in patients on continuous ambulatory PD. Center size was a powerful predictor of technique success. We conclude that the current state of PD in the United States is characterized by improving patient outcomes, higher technique success, and a predominance of use of cycler-based therapy. Several opportunities for improving technique success amenable to practice interventions have been identified.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / surgery
  • Kidney Failure, Chronic / therapy*
  • Kidney Transplantation / mortality
  • Male
  • Middle Aged
  • Peritoneal Dialysis / mortality*
  • Predictive Value of Tests
  • Renal Dialysis / mortality
  • Survival Analysis
  • United States / epidemiology