Insights Into Peritoneal Dialysis Outcomes: An Approach Using Competing Risks Analysis

• Tipo: Artigo em Revista Científica Internacional
• Data: 2025

Autores

Cunha, A (Autor) Outra; Braga, BG (Autor) Outra; Sousa, S (Autor) Outra; Inácio, A (Autor) Outra; Shilyaeva, Y (Autor) Outra; Tavares, J (Autor) Outra; Carvalho, MJ (Autor) Outra; Fonseca, I (Autor) Outra; Rodrigues, A (Autor) Outra; Teixeira, L (Autor) ICBAS

Revista

Título: Seminars in Dialysis

Vol. 38

Páginas: 207-213

ISSN: 0894-0959

Editora: Wiley-Blackwell

Indexação

ISI Web of Knowledge - 0 Citações

Scopus - 0 Citações

Outras Informações

ID Authenticus: P-018-JWA

DOI: 10.1111/sdi.13255

Abstract (EN): Peritoneal dialysis (PD) outcomes analysis presents challenges due to heterogeneous outcomes. Our study aims to evaluate mortality, transition to hemodialysis (HD), and kidney transplant (KT) rates and investigate potential baseline patient characteristics influencing these outcomes. We conducted an observational retrospective registry-based single-center cohort study involving 722 incident adult PD patients admitted between 1985 and 2022. Follow-up duration extended from PD initiation to the first occurrence of death (n = 143), transfer to HD (n = 313), or KT (n = 202). Utilizing competitive risks analysis, we calculated cumulative incidence (CI) functions and applied a Fine and Gray model to baseline variables to understand their impact. The majority of patients were female (n = 401; 55.54%), with an average age of 49.64 +/- 15.80 years. Transfer to HD had the highest probability (CI of 0.38 at 60 months), followed by KT (CI of 0.27 at 60 months) and death (CI of 0.19 at 60 months). Diabetes correlated solely with death (HR 1.71 (0.18); p = 0.004). PD-first was associated with a lower risk of HD transfer (HR 0.76 (0.13); p = 0.036) and positively influenced KT (HR 1.73 (0.16); p < 0.01). Vascular access as the reason for PD selection was associated with death (HR 2.16 (0.19); p < 0.001). The main risk for PD patients is transitioning to HD, unaffected by baseline patient characteristics. PD-first option positively influences KT access, and mortality rates remain low and unaffected by this option, ensuring the safety of the technique. Vascular access-related PD initiations correlate with increased mortality, potentially due to comorbidities.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 7