scholarly journals Erratum Regarding “Cost-Utility of Dialysis in Canada: Hemodialysis, Peritoneal Dialysis, and Nondialysis Treatment of Kidney Failure” (Kidney Med. 2021;3[1]:20-30)

2021 ◽  
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Failure ◽  
Cost Utility

Comparison of Hemodialysis and Peritoneal Dialysis — a Cost–Utility Analysis

2002 ◽  
Vol 22 (1) ◽  
pp. 39-47 ◽  
Author(s):  
Karin Sennfält ◽  
Martin Magnusson ◽  
Per Carlsson
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Peritoneal Dialysis ◽  
Kidney Failure ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Age Group ◽  
The Cost ◽  
Quality Adjusted Life

Objective Our aim was to compare both health-related quality of life and costs for hemodialysis (HD) and peritoneal dialysis (PD) in a defined population. Design Decision-tree modeling to estimate total costs and effects for two treatment strategies, HD and PD, among patients with chronic kidney failure, for 5 years following the start of treatment. Courses of events and health-care consumption were mapped in a retrospective matched-record study. Data on health status were obtained from a matched population by a quality-of-life questionnaire (EuroQol). The study has a societal perspective. Setting All dialysis departments in the southeastern health-care region of Sweden. Patients 136 patients with kidney failure, comprising 68 matched pairs, were included in a retrospective record study; 81 patients with kidney failure, comprising 27 matched triplets, were included in a prospective questionnaire study. Main Outcome Measures Cost per life year and cost per quality-adjusted life year. Results The cost per quality-adjusted life year for PD was lower in all analyzed age groups. There was a 12% difference in the age group 21 – 40 years, a 31% difference in the age group 41 – 60 years, and an 11% difference in the age group 61+ years. Peritoneal dialysis and HD resulted in similar frequencies of transplantation (50% and 41%, respectively) and expected survival (3.58 years and 3.56 years, respectively) during the first 5 years after the initiation of treatment. Conclusion The cost–utility ratio is most favorable for PD as the primary method of treatment for patients eligible for both PD and HD.

scholarly journals Cost-Utility of Dialysis in Canada: Hemodialysis, Peritoneal Dialysis, and Nondialysis Treatment of Kidney Failure

2020 ◽  
Author(s):  
Thomas W. Ferguson ◽  
Reid H. Whitlock ◽  
Ryan J. Bamforth ◽  
Alain Beaudry ◽  
Joseph Darcel ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Failure ◽  
Cost Utility

Peritoneal dialysis beyond kidney failure?

2018 ◽  
Vol 282 ◽  
pp. 3-12 ◽  
Author(s):  
Anna Pratsinis ◽  
Olivier Devuyst ◽  
Jean-Christophe Leroux
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Failure

scholarly journals Peritoneal dialysis - experiences

2010 ◽  
Vol 63 (11-12) ◽  
pp. 753-757 ◽  
Author(s):  
Tatjana Djurdjevic-Mirkovic
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Failure ◽  
Chronic Kidney Failure ◽  
Daily Basis ◽  
Chronic Glomerulonephritis ◽  
Terminal Stage ◽  
Common Causes ◽  
Dialysis Method ◽  
Living Related ◽  
Cadaveric Transplantation

Peritoneal dialysis is the method of treatment of terminal-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis. It is based on the principles of the diffusion of solutes and ultrafiltration of fluids across the peritoneal membrane, which acts as a filter. The dialysate is introduced into the peritoneum via the previously positioned peritoneal catheter. The peritoneal dialysis is carried out on daily basis, at home by the patient, and the ?exchange? is repeated 4-5 times during the 24 hours. The first steps in peritoneal dialysis at the Department for Haemodialysis of the Clinical Centre of Vojvodina date back to 1973. Until 1992, the patients were subjected to this program only sporadically. Since 1998 the peritoneal dialysis method has been performed at the Clinic for Nephrology and Clinical Immunology. In the period 1998-2008 ninety nine peritoneal catheters were placed. Chronic glomerulonephritis, nephroangiosclerosis and diabetes were identified as the most common causes of chronic renal failure. Two methods of catheter placement were applied: the standard open surgery method (majority of patients) and laparoscopy. Most of the patients were subjected to continuous ambulatory peritoneal dialysis, whereas four patients received automatic dialysis. Transplantation was performed in 10 patients, i.e. cadaveric transplantation and living-related donor transplantation, each in 5 patients. Peritoneal dialysis was available as a service outside our institution as well. A ten-year experience in peritoneal dialysis gained at our Centre has proved the advantages and qualities of this method, strongly supporting its wider application in the treatment of terminal-stage chronic kidney failure.

Morphine-6-Glucuronide might Mediate the Prolonged Opioid Effect of Morphine in Acute Renal Failure

1990 ◽  
Vol 9 (5) ◽  
pp. 317-321 ◽  
Author(s):  
Egil Bodd ◽  
Dag Jacobsen ◽  
Ellen Lund ◽  
Åse Ripel ◽  
Jørg Mørland ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Kidney Failure ◽  
Acute Kidney Failure ◽  
Morphine Treatment ◽  
Time Curve ◽  
Concentration Time ◽  
Toxic Metabolites ◽  
Elimination Half ◽  
Ethylene Glycol Poisoning

1 A 43-year-old male developed acute kidney failure due to ethylene glycol poisoning. He was treated with bicarbonate to combat metabolic acidosis, ethanol as an antimetabolite and haemodialysis to remove the glycol and its toxic metabolites. He was kept on a respirator and sedated with morphine. Peritoneal dialysis was given for 36 d. Following sedation with morphine for 11 d, the patient was given naloxone and then extubated. The antidote had to be continued for 14 d to prevent respiratory depression, until kidney function improved. 2 Only morphine-6-glucuronide (M-6-G) was found in the plasma and CSF at concentrations which might explain the opioid effects observed in the patient during the days after the cessation of morphine treatment. The ratio of the area under the concentration-time curve (AUC) of morphine-3-glucuronide (M-3-G) to M-6-G was 2:1. The elimination half-lives of M-3-G and M-6-G were 55 and 82 h, respectively. The clearance data indicate that most of the glucuronides were eliminated by peritoneal dialysis during renal failure. 3 The data suggest that M-6-G exerts opioid effects and is retained in acute kidney failure. Morphine should therefore not be used preferentially as a sedative/analgesic in pronounced kidney failure.

scholarly journals The ERA-EDTA Registry Annual Report 2018: a summary

2020 ◽  
Author(s):  
Anneke Kramer ◽  
Rianne Boenink ◽  
Vianda S Stel ◽  
Carmen Santiuste de Pablos ◽  
Filip Tomović ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Kidney Failure ◽  
Survival Probability ◽  
Living Donor ◽  
Annual Report ◽  
Deceased Donor ◽  
Aggregated Data ◽  
Kidney Replacement Therapy

Abstract Background The ERA-EDTA Registry collects data on kidney replacement therapy (KRT) via national and regional renal registries in Europe and countries bordering the Mediterranean Sea. This article summarizes the 2018 ERA-EDTA Registry Annual Report, and describes the epidemiology of KRT for kidney failure in 34 countries. Methods Individual patient data on patients undergoing KRT in 2018 was provided by 34 national or regional renal registries and aggregated data by 17 registries. The incidence and prevalence of KRT, the kidney transplantation activity and the survival probabilities of these patients were calculated. Results In 2018, the ERA-EDTA Registry covered a general population of 636 million people. Overall, the incidence of KRT for kidney failure was 129 per million population (pmp), 62% of patients were men, 51% were ≥65 years of age and 20% had diabetes mellitus as cause of kidney failure. Treatment modality at the onset of KRT was haemodialysis for 84%, peritoneal dialysis for 11% and pre-emptive kidney transplantation for 5% of patients. On 31 December 2018, the prevalence of KRT was 897 pmp, with 57% of patients on haemodialysis, 5% on peritoneal dialysis, and 38% living with a kidney transplant. The transplant rate in 2018 was 35 pmp: 68% received a kidney from a deceased donor, 30% from a living donor, and for 2% the donor source was unknown. For patients commencing dialysis during 2009-2013, the unadjusted 5-year survival probability was 42.6%. For patients receiving a kidney transplant within this period the unadjusted 5-year survival probability was 86.6% for recipients of deceased donor grafts, and 93.9% for recipients of living donor grafts.

scholarly journals Efficacy of peritoneal dialysis in the treatment of refractory heart failure

2018 ◽  
Vol 1 (1) ◽  
pp. 27-34
Author(s):  
J.Emilio Sánchez ◽  
Carmen Rodríguez ◽  
Elena Astudillo ◽  
José Joaquín Bande
Keyword(s):  
Heart Failure ◽  
Peritoneal Dialysis ◽  
Functional Status ◽  
Randomized Study ◽  
Systolic Pressure ◽  
Cost Utility ◽  
Pulmonary Artery Systolic Pressure ◽  
State Of Health ◽  
Adequate Treatment ◽  
Fluid Removal

Heart failure (HF) is a progressive disorder even with adequate treatment. Fluid removal may aid in the management of these patients. We evaluated the efficacy of peritoneal dialysis (PD) in the treatment of refractory HF.Patients and Methods : Prospective, non-randomized study involving patients with congestive HF refractory to maximun tolerable drug treatment. All of them were treated with PD. We analysed clinical data and functional status. To determine efficacy we compared the perceived state of health to PD patients respect to those reported with conservative therapies. Finally, we carried out a cost-utility evaluation.Results : Seventy-eight patients (68% men, 66±10 years) were included and 14 were still undergoing PD at the end of the follow-up period (22±9 months). Seventy patients underwent only one daily nocturnal exchange; the rest, 2 or 3 exchanges according to different degrees of renal failure. All of them improved their NYHA functional status, (4% three classes, 63% two, 33% one; p<0.001), with a reduction in their pulmonary artery systolic pressure (48±13 vs 28±10 mmHg; p=0.007). Hospitalization rates underwent a dramatic reduction (from 63±16 to 9±7 days/patient/year; p=0.002). Life expectancy on PD was 88% after 12 months of treatment, and 72% and 54% after 18 and 24 months. PD was associated with a perceived state of health higher than with conservative therapy, (0,416±0,218 vs 0, 658±0,114, p <0.02 ). PD is cost-effective compared with the diuretic regimens.Conclusions : PD is a good option for patients with refractory HF; it improves the functional status and quality of life, reduces morbidity, mortality and health care costs.

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