Time-dependent incidence rates and risk factors for transferring to hemodialysis in patients on peritoneal dialysis under the Thai PD-First Policy.

Autor:	Sangthawan P; Division of Nephrology, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Thailand., Ingviya T; Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Thailand., Thokanit NS; Ramathibodi Comprehensive Cancer Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand., Janma J; Division of Nephrology, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand., Changsirikulchai S; Division of Nephrology, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand.
Jazyk:	angličtina
Zdroj:	Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis [Perit Dial Int] 2023 Jan; Vol. 43 (1), pp. 64-72. Date of Electronic Publication: 2022 Mar 03.
DOI:	10.1177/08968608221081521
Abstrakt:	Background: Haemodialysis (HD) transfer (HDT) is the major challenge of peritoneal dialysis (PD). This study aimed to analyse the time-dependent incidence rates and risk factors for permanent HDT in patients under Thailand's PD First policy. Methods: The records of 20,545 patients from January 2008 to June 2018 were studied. The time on therapy (TOT) was divided into 0-3, 3-12, 12-24, 24-36, 36-48 and more than 48 months. The time-dependent incidence rates and causes of PD dropout were investigated. The risk factors for HDT were analysed by multivariable Poisson regression model and presented as incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Results: The main cause of PD dropout was death (45.7%) with 17.4% of the patients transferred to HD. The median (25th to 75th interquartile range) dialysis vintage was 1.4 (0.5-2.7) years. The incidence rates of HDT increased with TOT. Patients with universal coverage were transferred to HD less frequently than those with other health schemes. Patients who were illiterate or only had primary school education had a higher risk of being transferred to HD after 48 months of TOT (IRR 1.41 (95% CI 1.07-1.89)). Peritonitis within the first year of PD was the risk for HDT during 13-48 months of PD. The reasons for HDT changed with TOT. Mechanical complications followed by peritonitis were the main causes of HDT during the first 3 months, and after that peritonitis was the main reason. Conclusions: The incidence of HDT increased with TOT. The risks for HDT changed over time on PD.
Databáze:	MEDLINE
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