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May 13, 2021Journal of Nephrology

Burden and causes of hospital admissions and readmissions in patients undergoing hemodialysis and peritoneal dialysis: a nationwide study

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Key result

Peritoneal dialysis linked to ~7% higher hospitalization risk and increased in-hospital death versus hemodialysis.

  • HR 1.07
  • 95% CI 1.01-1.13
  • n=8,902

Why the study?

High rates of hospitalization in dialysis patients impose an increasing healthcare burden, and comparative data on hospital admissions and causes between hemodialysis and peritoneal dialysis patients are needed.

Does peritoneal dialysis compared to hemodialysis affect the risk of hospital admission and in-hospital death in patients starting maintenance dialysis?

Population

8902 patients starting maintenance dialysis in Sweden between 2006 and 2016

Comparison

Peritoneal dialysis vs hemodialysis

Design

Observational study

Follow-up

2 years

Authors

YXYang XuLLLongkai LiMEMarie Evans

Discussion

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Member takes

Overview

Should not alter initial dialysis modality selection; observational data leave open residual confounding and need for randomized confirmation.

Study Design

Type

Observational (n=8,902)

Multicenter

Yes

Structured PICO

Does peritoneal dialysis compared to hemodialysis affect the risk of hospital admission and in-hospital death in patients starting maintenance dialysis?

P
Population
8,902 patients who started maintenance hemodialysis or peritoneal dialysis in Sweden between 2006 and 2016, followed for 2 years.
E
Exposure
Peritoneal dialysis (PD)
C
Comparator
Hemodialysis (HD)
O
Outcome
Hospital admission and in-hospital deathhard clinical

Main Result

Hazard Ratio: 1.07 (95% CI 1.01–1.13)

Patients starting peritoneal dialysis have a slightly higher risk of hospitalization, longer hospital stays, and higher in-hospital mortality compared to those starting hemodialysis, with cardiovascular events and infections driving admissions.

Cite This Study

Xu et al. (2021) conducted an observational in Maintenance dialysis (n=8,902). Peritoneal dialysis (PD) vs. Hemodialysis (HD) was evaluated on Hospital admission (HR 1.07, 95% CI 1.01-1.13). Compared with hemodialysis, patients on peritoneal dialysis had a higher risk of hospitalization (HR 1.07; 95% CI 1.01-1.13) and in-hospital death (HR 1.18; 95% CI 1.03-1.37).

synapsesocial.com/papers/6ab0d740482f52be09f7f11chttps://doi.org/10.1007/s40620-021-01023-z
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reasons for admission and predictors of national 30-day readmission rates in patients with end-stage renal disease on peritoneal dialysis2017 · 20 citations
  2. 2National Estimates of 30-Day Unplanned Readmissions of Patients on Maintenance Hemodialysis2017 · 37 citations
  3. 3Rehospitalizations and Emergency Department Visits after Hospital Discharge in Patients Receiving Maintenance Hemodialysis2015 · 84 citations
  4. 4Readmission within 30 days of Hospital Discharge among Children Receiving Chronic Dialysis2014 · 17 citations
  5. 5eHealth interventions to support patients in delivering and managing peritoneal dialysis at home: A systematic review2020 · 34 citations