HANAFUSA Norio
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title Predictors of outcomes in patients on peritoneal dialysis:A2-year nationwide cohort study
Journal Formal name：Scientific Reports
Abbreviation：Sci Rep
ISSN code：20452322
Domestic / ForeginForegin
Volume, Issue, Page 9(1),pp.3967
Author and coauthor Abe Masanori, Hamano Takayuki, Hoshino Junichi, Wada Atsushi, Nakai Shigeru, Hanafusa Norio, Masakane Ikuto, Nitta Kosaku, Nakamoto Hidetomo
Publication date 2019/03/08
Summary There has been no nationwide study of prognostic factors and outcomes in patients on peritoneal dialysis (PD) in Japan. We conducted a cohort study using data from the nationwide registry of the Japanese Society for Dialysis Therapy. We followed 8,954 prevalent PD patients for 2 years, 2014-2015. Cox proportional hazards regression analysis was used to determine factors that were independently associated with patient survival. Survival rates were compared between patients with and without diabetes after adjusting for potential confounders. During the 2-year study period, 893 (10.0%) of 8,954 patients died, 148 (1.6%) underwent kidney transplantation, and 2,637 (29.4%) were switched to hemodialysis; 5,276 (58.9%) patients were alive at the end of the study period. After multivariate adjustment, older age, longer duration of dialysis, presence of diabetes, cardiovascular comorbidity, use of 2.5% glucose dialysate, higher C-reactive protein and phosphate levels, and a lower serum albumin level were independently associated with increased hazard ratios for all-cause mortality. A combination of PD and hemodialysis was associated with a lower mortality rate. The new-onset cardiovascular event rate was significantly higher in the diabetes group than in the non-diabetes group (P < 0.0001). After adjusting for all variables, the hazard ratio was 1.509 (95% confidence interval 1.029-2.189, P = 0.036) in the diabetes group. Diabetes, older age, longer duration of dialysis, cardiovascular comorbidity, and inflammation were predictors of mortality in patients on PD.
DOI 10.1038/s41598-019-40692-6
PMID 30850727