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Kidney Week

Abstract: PO0990

Associations Between Loop Diuretic Use and Outcomes Among Patients Treated with Peritoneal Dialysis

Session Information

  • Peritoneal Dialysis
    November 04, 2021 | Location: On-Demand, Virtual Only
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Luo, Jiacong, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Cohen, Dena E., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Colson, Carey, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Tentori, Francesca, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Schreiber, Martin J., DaVita Inc, Denver, Colorado, United States
Background

Among hemodialysis patients, an active loop diuretic prescription at the time of dialysis initiation is associated with a lower hospitalization rate and other favorable outcomes, compared to no prescription. Whether this finding extends to patients initiating peritoneal dialysis (PD) is not known.

Methods

Data used for this retrospective study comprised electronic health records and US Renal Data System claims data merged through direct linkage. Included patients initiated PD at a large dialysis organization between 01 Jan 2006 and 30 June 2014, were nonoliguric at dialysis start (24-hour urine collection >200 cc), and had Medicare insurance. Exposure was determined on the basis of an active, filled supply for a loop diuretic spanning day 90 of PD. Outcomes were considered from day 91 of PD through the first of death, loss to follow-up, or study end (31 Dec 2014) and were compared across exposure groups using appropriate statistical models adjusted for imbalanced patient characteristics.

Results

Among patients initiating PD with a loop diuretic prescription (N=792), the hospitalization rate during follow-up was 1.77 admissions/patient-year (pt-yr), compared to 1.75/pt-year for those without (N=1363), corresponding to an adjusted incidence rate ratio (aIRR) of 1.05 (95% confidence interval [CI] 0.97-1.15). Mortality was likewise comparable between groups, with crude rates of 0.21 and 0.18 deaths/pt-yr, respectively (aIRR 1.05, 95% CI 0.82-1.35). No substantial differences were observed between exposure groups with respect to serum potassium, renal Kt/V, or time to transition to hemodialysis.

Conclusion

Among patients initiating PD, no beneficial associations were observed between loop diuretic use and any of the outcomes examined.