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. 2024 Dec 3;14(1):30109.
doi: 10.1038/s41598-024-81934-6.

Effects of initial peritoneal dialysis prescription on clinical outcomes in Japanese peritoneal dialysis patients: a cohort study

Tsutomu Sakurada  1 , Junhui Zhao  2 , Charlotte Tu  2 , Brian Bieber  2 , Melissa Cheetham  3 , Ronald L Pisoni  2 , Jeffrey Perl  4 , Ken Tsuchiya  5   6 , Hideki Kawanishi  7   6 , Jun Minakuchi  8   6
Affiliations

Effects of initial peritoneal dialysis prescription on clinical outcomes in Japanese peritoneal dialysis patients: a cohort study

Tsutomu Sakurada et al. Sci Rep. .

Abstract

Effects of the initial peritoneal dialysis (PD) prescription on clinical outcomes are unknown in Japan. We conducted a cohort study using data from Peritoneal Dialysis Outcomes and Practice Patterns Study. The patients were divided into two groups by the volume of the initial PD prescription (≤ 4 L/day or > 4 L/day). Cause-specific Cox proportional hazards survival models were used to model the association between different PD prescriptions and the clinical outcomes. The outcomes included transfer to HD, mortality, the composite of mortality and transfer to HD, peritonitis, hospitalization, and the patient-reported outcomes (PROs). Of the 342 patients, 98 were prescribed ≤ 4 L/day, and 244 were prescribed > 4 L/day. Patients prescribed ≤ 4 L/day were older with a lower percentage being male, had more cardiovascular and cerebrovascular disease but lower diabetes prevalence, were more likely to be receiving CAPD, used more assisted PD, and had lower BMI and mean serum creatinine levels. There were no significant differences between groups in terms of transfer to HD, mortality, transfer to HD or mortality, hospitalization, incidence of peritonitis, and PROs. Patients with initial PD prescriptions of ≤ 4 L/day compared to > 4 L/day had similar clinical outcomes. This practice may provide health economic benefits in Japan.

Keywords: Incremental peritoneal dialysis; Mortality; Peritoneal dialysis prescription; Peritonitis; Transfer to hemodialysis.

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Conflict of interest statement

Competing interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors have read and understood Peritoneal Dialysis International’s policy on conflicts of interest disclosures. T. S. has received speaker honorarium from Baxter Healthcare and received research grant from Terumo Corporation. J. Z., C. T., B.B. and R, L. P. are employees of Arbor Research Collaborative for Health, which administers the DOPPS programs. M. C. has received travel support from Amgen and is supported by a Queensland Advancing Clinical Research Fellowship. J. P. has received speaking honoraria from AstraZeneca, Baxter Healthcare, DaVita Healthcare Partners, Fresenius Medical Care, Dialysis Clinics Incorporated and Satellite Healthcare. He has served as a consultant for Baxter Healthcare, DaVita Healthcare Partners, Fresenius Medical Care and LiberDi. K. T., H. K. and J. M. declare that they have no relevant financial interest. Ethics approval and consent to participate: All methods were carried out in accordance with relevant guidelines and regulations. Study approval was obtained from a central institutional review board. Additional study approval and patient consent were obtained as required by national and local ethics committee regulations. Written informed consent was obtained from all patients eligible for study participation in accordance with the Declaration of Helsinki.

Figures

Fig. 1
Fig. 1
Study flow chart. PD; peritoneal dialysis, HD; hemodialysis, PDOPPS; Peritoneal Dialysis Outcomes and Practice Patterns Study.
Fig. 2
Fig. 2
PD volume trajectories for ≤ 4 L/day and > 4 L/day in incident Japanese PD patients. PD; peritoneal dialysis.
See this image and copyright information in PMC

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