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The impact of multidisciplinary pre-dialysis care on the outcomes of incident peritoneal dialysis patients

Authors :
I-Kuan Wang
Tung-Min Yu
Tzung-Hai Yen
Hei-Tung Yip
Ping-Chin Lai
Chi-Yuan Li
Kuo-Ting Sun
Fung-Chang Sung
Source :
BMC Nephrology, Vol 23, Iss 1, Pp 1-8 (2022)
Publication Year :
2022
Publisher :
BMC, 2022.

Abstract

Abstract Background This study aims to evaluate the impact of multidisciplinary pre-dialysis care (MDPC) on the risks of peritonitis, technique failure and mortality in peritoneal dialysis (PD) patients. Methods Incident end-stage kidney disease patients who received peritoneal dialysis (PD) for more than 90 days were recruited in this study from 1 January 1, 2007 to December 31, 2018. Patients were classified into two groups, the MDPC group and the control group, that received the usual care by nephrologists. Risks of the first episode of peritonitis, technique failure and mortality were compared between the two groups. Results There were 126 patients under the usual care and 546 patients under the MDPC. Patients in the MDPC group initiated dialysis earlier than those in the non-MDPC group. There was no significant difference between these two groups in time to the first episode of peritonitis. Compared to the non-MDPC group, the MDPC group was at similar risks of technique failure (adjusted HR = 0.85, 95% CI = 0.64–1.15) and mortality (adjusted HR = 0.66, 95% CI = 0.42–1.02). Among patients with diabetes, the risk of mortality was significantly reduced in the MDPC group with an adjusted HR of 0.45 (95% CI = 0.25–0.80). Conclusions There was no significant difference in time to develop the first episode of peritonitis, and risks of technique failure and mortality between these two groups. Diabetic PD patients under MDPC had a lower risk of mortality than those under the usual care.

Details

Language :
English
ISSN :
14712369
Volume :
23
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Nephrology
Publication Type :
Academic Journal
Accession number :
edsdoj.2841ce90e6e74778a9f1e335f9603407
Document Type :
article
Full Text :
https://doi.org/10.1186/s12882-022-02800-z