Impact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patients

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dc.contributor.authorSpigolon, Dandara N.
dc.contributor.authorDe Moraes, Thyago P.
dc.contributor.authorFigueiredo, Ana E.
dc.contributor.authorModesto, Ana Paula
dc.contributor.authorBarretti, Pasqual [UNESP]
dc.contributor.authorBastos, Marcus Gomes
dc.contributor.authorBarreto, Daniela V.
dc.contributor.authorPecoits-Filho, Roberto
dc.contributor.institutionPontifícia Universidade Católica Do Paraná (PUCPR)
dc.contributor.institutionPontifícia Universidade Católica Do Rio Grande Do sul (PUCRS)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionUniversidade Federal de Juiz de Fora-UFJF
dc.date.accessioned2018-12-11T17:27:34Z
dc.date.available2018-12-11T17:27:34Z
dc.date.issued2016-04-01
dc.description.abstractBackground: Structured pre-dialysis care is associated with an increase in peritoneal dialysis (PD) utilization, but not with peritonitis risk, technical and patient survival. This study aimed at analyzing the impact of pre-dialysis care on these outcomes. Methods: All incident patients starting PD between 2004 and 2011 in a Brazilian prospective cohort were included in this analysis. Patients were divided into 2 groups: early pre-dialysis care (90 days of follow-up by a nephrology team); and late pre-dialysis care (absent or less than 90 days follow-up). The socio-demographic, clinical and biochemical characteristics between the 2 groups were compared. Risk factors for the time to the first peritonitis episode, technique failure and mortality based on Cox proportional hazards models. Results: Four thousand one hundred seven patients were included. Patients with early pre-dialysis care presented differences in gender (female-47.0 vs. 51.1%, p = 0.01); race (white-63.8 vs. 71.7%, p < 0.01); education (<4 years-61.9 vs. 71.0%, p < 0.01), respectively, compared to late care. Patients with early pre-dialysis care presented a higher prevalence of comorbidities, lower levels of creatinine, phosphorus, and glucose with a significantly better control of hemoglobin and potassium serum levels. There was no impact of pre-dialysis care on peritonitis rates (hazard ratio (HR) 0.88; 95% CI 0.77-1.01) and technique survival (HR 1.12; 95% CI 0.92-1.36). Patient survival (HR 1.20; 95% CI 1.03-1.41) was better in the early pre-dialysis care group. Conclusion: Earlier pre-dialysis care was associated with improved patient survival, but did not influence time to the first peritonitis nor technique survival in this national PD cohort.en
dc.description.affiliationSchool of Medicine Pontifícia Universidade Católica Do Paraná (PUCPR), Rua Imaculada Conceição, 1155
dc.description.affiliationPontifícia Universidade Católica Do Rio Grande Do sul (PUCRS)
dc.description.affiliationUniversidade Estadual Paulista-UNESP
dc.description.affiliationUniversidade Federal de Juiz de Fora-UFJF
dc.description.affiliationUnespUniversidade Estadual Paulista-UNESP
dc.format.extent104-111
dc.identifierhttp://dx.doi.org/10.1159/000444401
dc.identifier.citationAmerican Journal of Nephrology, v. 43, n. 2, p. 104-111, 2016.
dc.identifier.doi10.1159/000444401
dc.identifier.file2-s2.0-84961219473.pdf
dc.identifier.issn1421-9670
dc.identifier.issn0250-8095
dc.identifier.lattes5496411983893479
dc.identifier.orcid0000-0003-4979-4836
dc.identifier.scopus2-s2.0-84961219473
dc.identifier.urihttp://hdl.handle.net/11449/177887
dc.language.isoeng
dc.relation.ispartofAmerican Journal of Nephrology
dc.relation.ispartofsjr1,480
dc.relation.ispartofsjr1,480
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectClinical outcomes
dc.subjectPeritoneal dialysis
dc.subjectPre-dialysis care
dc.subjectSurvival
dc.titleImpact of Pre-Dialysis Care on Clinical Outcomes in Peritoneal Dialysis Patientsen
dc.typeArtigo
unesp.author.lattes5496411983893479[5]
unesp.author.orcid0000-0003-4979-4836[5]

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Artigos - Clínica Médica - FMB