CHARACTERIZATION OF THE BRAZPD II COHORT AND DESCRIPTION OF TRENDS IN PERITONEAL DIALYSIS OUTCOME ACROSS TIME PERIODS

Página do item simplificado
dc.contributor.authorMoraes, Thyago Proenca de
dc.contributor.authorFigueiredo, Ana Elizabeth
dc.contributor.authorCampos, Ludimila Guedim de
dc.contributor.authorOlandoski, Marcia
dc.contributor.authorBarretti, Pasqual [UNESP]
dc.contributor.authorPecoits-Filho, Roberto
dc.contributor.institutionPontificia Univ Catolica Parana PUCPR
dc.contributor.institutionPontificia Univ Catolica Rio de Janeiro
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2015-03-18T15:56:21Z
dc.date.available2015-03-18T15:56:21Z
dc.date.issued2014-11-01
dc.description.abstractObservational studies from different regions of the world provide valuable information in patient selection, clinical practice, and their relationship to patient and technique outcome. The present study is the first large cohort providing patient characteristics, clinical practice, patterns and their relationship to outcomes in Latin America. The objective of the present study was to characterize the cohort and to describe the main determinants of patient and technique survival, including trends over time of peritoneal dialysis (PD) initiation and treatment.This was a nationwide cohort study in which all incident adult patients on PD from 122 centers were studied. Patient demographics, socioeconomic and laboratory values were followed from December 2004 to January 2011 and, for comparison purposes, divided into 3 groups according to the year of starting PD: 2005/06, 2007/08 and 2009/10. Patient survival and technique failure (TF) were analyzed using the competing risk model of Fine and Gray. All patients active at the end of follow-up were treated as censored. In contrast, all patients who dropped the study for any reason different from the primary event of interest were treated as competing risk. Significance was set to a p level of 0.05.A total of 9,905 patients comprised the adult database, 7,007 were incident and 5,707 remained at least 90 days in PD. The main cause of dropout was death (54%) and of TF was peritonitis (63%). Technique survival at 1, 2, 3, 4, and 5 years was 91%, 84%, 77%, 68%, and 58%, respectively. There was no change in TF during the study period but 3 independent risk factors were identified: lower center experience, lower age, and automated PD (APD) as initial therapy. Cardiovascular disease (36%) was the main cause of death and the overall patient survival was 85%, 74%, 64%, 54%, and 48% at 1, 2, 3, 4, and 5 years, respectively. Patient survival improved along all study periods: compared to 2005/2006, patients starting at 2007/2008 had a relative risk reduction (SHR) of 0.83 (95% confidence interval [CI] 0.72-0.95); and starting in 2009/2010 of 0.69 (95% CI 0.57-0.83). The independent risk factors for mortality were diabetes, age > 65 years, previous hemodialysis, starting PD modality, white race, low body mass index (BMI), low educational level, center experience, length of pre-dialysis care, and the year of starting PD.We observed an improvement in patient survival along the years. This finding was sustained even after correction for several confounders and using a competing risk approach. On the other hand, no changes in technique survival were found.en
dc.description.affiliationPontificia Univ Catolica Parana PUCPR, Sch Med, Curitiba, Parana, Brazil
dc.description.affiliationPontificia Univ Catolica Rio de Janeiro, Grad Program Med & Hlth Sci, Porto Alegre, RS, Brazil
dc.description.affiliationUNESP, Sch Med, Botucatu, SP, Brazil
dc.description.affiliationUnespUNESP, Sch Med, Botucatu, SP, Brazil
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipBaxter Healthcare
dc.description.sponsorshipPUCPR
dc.description.sponsorshipClinical Evidence Council Program from Baxter Healthcare
dc.format.extent714-723
dc.identifierhttp://dx.doi.org/10.3747/pdi.2013.00282
dc.identifier.citationPeritoneal Dialysis International. Toronto: Multimed Inc, v. 34, n. 7, p. 714-723, 2014.
dc.identifier.doi10.3747/pdi.2013.00282
dc.identifier.issn0896-8608
dc.identifier.lattes5496411983893479
dc.identifier.orcid0000-0003-4979-4836
dc.identifier.urihttp://hdl.handle.net/11449/117527
dc.identifier.wosWOS:000346465800009
dc.language.isoeng
dc.publisherMultimed Inc
dc.relation.ispartofPeritoneal Dialysis International
dc.relation.ispartofjcr2.009
dc.relation.ispartofsjr1,089
dc.rights.accessRightsAcesso restrito
dc.sourceWeb of Science
dc.subjectPeritoneal dialysisen
dc.subjecttrendsen
dc.subjectcomplicationsen
dc.subjectoutcomeen
dc.subjectmortalityen
dc.titleCHARACTERIZATION OF THE BRAZPD II COHORT AND DESCRIPTION OF TRENDS IN PERITONEAL DIALYSIS OUTCOME ACROSS TIME PERIODSen
dc.typeArtigo
dcterms.rightsHolderMultimed Inc
unesp.author.lattes5496411983893479[5]
unesp.author.orcid0000-0002-8555-8649[2]
unesp.author.orcid0000-0003-4979-4836[5]
unesp.author.orcid0000-0002-0255-6710[6]
unesp.author.orcid0000-0002-2983-3968[1]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

Arquivos

Coleções

Artigos - Clínica Médica - FMB