Automated peritoneal dialysis is associated with better survival rates compared to continuous ambulatory peritoneal dialysis: a propensity score matching analysis

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dc.contributor.authorBeduschi, Gabriela de Carvalho [UNESP]
dc.contributor.authorFigueiredo, Ana Elizabeth
dc.contributor.authorOlandoski, Marcia [UNESP]
dc.contributor.authorPecoits-Filho, Roberto [UNESP]
dc.contributor.authorBarretti, Pasqual
dc.contributor.authorde Moraes, Thyago Proenca [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionPontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
dc.contributor.institutionPontifícia Universidade Católica do Paraná (PUCPR)
dc.date.accessioned2015-12-07T15:35:35Z
dc.date.available2015-12-07T15:35:35Z
dc.date.issued2015
dc.description.abstractThe impact of peritoneal dialysis modality on patient survival and peritonitis rates is not fully understood, and no large-scale randomized clinical trial (RCT) is available. In the absence of a RCT, the use of an advanced matching procedure to reduce selection bias in large cohort studies may be the best approach. The aim of this study is to compare automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) according to peritonitis risk, technique failure and patient survival in a large nation-wide PD cohort. This is a prospective cohort study that included all incident PD patients with at least 90 days of PD recruited in the BRAZPD study. All patients who were treated exclusively with either APD or CAPD were matched for 15 different covariates using a propensity score calculated with the nearest neighbor method. Clinical outcomes analyzed were overall mortality, technique failure and time to first peritonitis. For all analysis we also adjusted the curves for the presence of competing risks with the Fine and Gray analysis. After the matching procedure, 2,890 patients were included in the analysis (1,445 in each group). Baseline characteristics were similar for all covariates including: age, diabetes, BMI, Center-experience, coronary artery disease, cancer, literacy, hypertension, race, previous HD, gender, pre-dialysis care, family income, peripheral artery disease and year of starting PD. Mortality rate was higher in CAPD patients (SHR1.44 CI95%1.21-1.71) compared to APD, but no difference was observed for technique failure (SHR0.83 CI95%0.69-1.02) nor for time till the first peritonitis episode (SHR0.96 CI95%0.93-1.11). In the first large PD cohort study with groups balanced for several covariates using propensity score matching, PD modality was not associated with differences in neither time to first peritonitis nor in technique failure. Nevertheless, patient survival was significantly better in APD patients.en
dc.description.affiliationSchool of Medicine, UNESP, Botucatu, Brazil
dc.description.affiliationGraduate Program in Medicine and Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
dc.description.affiliationSchool of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
dc.description.affiliationUnespSchool of Medicine, UNESP, Botucatu, Brazil
dc.identifierhttp://dx.doi.org/10.1371/journal.pone.0134047
dc.identifier.citationPlos One, v. 10, n. 7, 2015.
dc.identifier.doi10.1371/journal.pone.0134047
dc.identifier.filePMC4516259.pdf
dc.identifier.issn1932-6203
dc.identifier.lattes5496411983893479
dc.identifier.orcid0000-0003-4979-4836
dc.identifier.pmcPMC4516259
dc.identifier.pubmed26214801
dc.identifier.urihttp://hdl.handle.net/11449/131444
dc.language.isoeng
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.relation.ispartofjcr2.766
dc.relation.ispartofsjr1,164
dc.rights.accessRightsAcesso aberto
dc.sourcePubMed
dc.titleAutomated peritoneal dialysis is associated with better survival rates compared to continuous ambulatory peritoneal dialysis: a propensity score matching analysisen
dc.typeArtigo
dcterms.rightsHolderPublic Library Science
unesp.author.lattes5496411983893479[5]
unesp.author.orcid0000-0003-4979-4836[5]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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