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. 2022 Jun;52(6):e13758.
doi: 10.1111/eci.13758. Epub 2022 Feb 15.

Differences in hospitalisation between peritoneal dialysis and haemodialysis patients

Anita van Eck van der Sluijs  1 , Anna A Bonenkamp  2 , Vera A van Wallene  1 , Tiny Hoekstra  2 , Birgit I Lissenberg-Witte  3 , Friedo W Dekker  4 , Frans J van Ittersum  2 , Marianne C Verhaar  1 , Brigit C van Jaarsveld  2   5 , Alferso C Abrahams  1 ; DOMESTICO study group
Collaborators, Affiliations

Differences in hospitalisation between peritoneal dialysis and haemodialysis patients

Anita van Eck van der Sluijs et al. Eur J Clin Invest. 2022 Jun.

Abstract

Background: Dialysis is associated with frequent hospitalisations. Studies comparing hospitalisations between peritoneal dialysis (PD) and haemodialysis (HD) report conflicting results and mostly analyse data of patients that remain on their initial dialysis modality. This cohort study compares hospitalisations between PD and HD patients taking into account transitions between modalities.

Methods: The Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes collected hospitalisation data of patients who started dialysis between 2012 and 2017. Primary outcome was hospitalisation rate, analysed with a multi-state model that attributed each hospitalisation to the current dialysis modality.

Results: In total, 695 patients (252 PD, 443 HD) treated in 31 Dutch hospitals were included. The crude hospitalisation rate for PD was 2.3 ( ± 5.0) and for HD 1.4 ( ± 3.2) hospitalisations per patient-year. The adjusted hazard ratio for hospitalisation rate was 1.1 (95%CI 1.02-1.3) for PD compared with HD. The risk for first hospitalisation was 1.3 times (95%CI 1.1-1.6) higher for PD compared with HD during the first year after dialysis initiation. The number of hospitalisations and number of hospital days per patient-year were significantly higher for PD. The most common causes of PD and HD hospitalisations were peritonitis (23%) and vascular access-related problems (33%).

Conclusion: PD was associated with higher hospitalisation rate, higher risk for first hospitalisation and higher number of hospitalisations compared with HD. Since the PD hospitalisations were mainly caused by peritonitis, more attention to infection prevention is necessary for reducing the number of hospitalisations in the future.

Keywords: end-stage kidney disease; haemodialysis; hospitalisation; peritoneal dialysis.

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Conflict of interest statement

A.E.S. and A.C.A. have received speaker honoraria from Baxter Healthcare. All other authors declare no conflict of interest. The results in this article have not been published previously in whole or part, except in abstract format.

Figures

FIGURE 1
FIGURE 1
Risk for first hospitalisation for PD and HD patients
See this image and copyright information in PMC

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