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Abstract: TH-PO371

Regional Variation in Peritoneal Dialysis (PD) Time on Therapy (ToT): Results from the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada
  • Zhao, Junhui, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Davies, Simon J., Keele University, Stoke-on-Trent, United Kingdom
  • Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan
  • Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Sloand, James A., JAS Renaissance, Chicago, Illinois, United States
  • Sanabria, Mauricio, RTS Baxter, Bogota, Colombia
  • Kanjanabuch, Talerngsak, Chulalongkorn University, Bangkok, Thailand
  • Kim, Yong-Lim, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Shen, Jenny I., LaBiomed at Harbor-UCLA, Torrance, California, United States
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background

Transition to hemodialysis (HD) carries significant morbidity and reduced quality of life for PD patients. PDOPPS seeks to identify practices aimed at meaningfully prolonging technique survival on PD. Here we describe PD discontinuation and death rate in PDOPPS.

Methods

PDOPPS is a prospective cohort study of randomly selected patients across national samples of PD facilities from Australia/New Zealand (A/NZ), Canada, Japan, Thailand, the UK, and the US. The study population included 20532 patients who were followed until death (on PD) or permanent switch to HD, based on initial designation as a permanent transfer or a temporary transfer with no return at 12 weeks. ToT (from PD start to death or permanent transfer to HD) and hazard ratios (HR) were estimated using Cox models based on PD vintage at study entry (age, sex, and diabetes adjusted).

Results

16% of patients transferred to HD and 13% of patients died. Median (IQR) ToT was 3.0 (1.3-5.7) years, ranging from 2.3 (1.1-4.4) in the UK to 4.5 (2.3-9.0) in Japan. Relative to the US, HR (95% CI) for transfer to HD were similar in Japan, Canada, and A/NZ, lower in Thailand (0.5, 0.3-0.7), and higher in the UK (1.5, 1.0-2.0). Compared to the US, HR for death was lower in Japan (0.4, 0.3-0.5), higher in Thailand (1.9, 1.4-2.5), and similar in A/NZ, Canada, and the UK. Variation in death, and transfer to HD (was seen across facilities [figure].

Conclusion

In PDOPPS, rates of permanent transfer to HD, and death vary significantly by country and facility. Future work will identify reasons for variation in PD outcomes, and identify practices to reduce the risk of PD attrition.

Funding

  • Commercial Support