Centre characteristics associated with the risk of peritonitis in peritoneal dialysis: a hierarchical modelling approach based on the data of the French Language Peritoneal Dialysis Registry

IntroductionThis study was carried out to investigate the center effect on the risk of peritoneal dialysis (PD) failure within the first 6 months of therapy using a multilevel approach.MethodsThis was a retrospective cohort study based on data from the French Language Peritoneal Dialysis Registry. We analyzed 5,406 incident patients starting PD between January 2008 and December 2012 in 128 PD centers. The end of the observation period was December 31, 2013.ResultsOf the 5,406 patients, 415 stopped PD within the first 6 months. There was a significant heterogeneity between centers (variance of the random effect: 0.10). Only 3% of the variance of the event of interest was attributable to differences between centers. At the individual level, only treatment before PD (odds ratio [OR]: 1.93 for hemodialysis and OR: 2.29 for renal transplantation) and underlying nephropathy ( p < 0.01) were associated with early PD failure. At the center level, only center experience was associated (OR: 0.78) with the risk of PD failure. Center effect accounted for 52% of the disparities between centers.ConclusionCenter effect on early PD failure is significant. Center experience is associated with a lower risk of transfer to hemodialysis.

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A hierarchical modelling approach to estimating humpback whale abundance from sand lance abundance

Ecological Modelling ◽

10.1016/j.ecolmodel.2021.109662 ◽

2021 ◽

Vol 456 ◽

pp. 109662

Author(s):

Tammy L. Silva ◽

David N. Wiley ◽

Gavin Fay

Keyword(s):

Humpback Whale ◽

Sand Lance ◽

Hierarchical Modelling ◽

Modelling Approach

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Impact of Assisted Peritoneal Dialysis Modality on Outcomes: A Cohort Study of the French Language Peritoneal Dialysis Registry

American Journal of Nephrology ◽

10.1159/000494664 ◽

2018 ◽

Vol 48 (6) ◽

pp. 425-433 ◽

Cited By ~ 7

Author(s):

Solène Guilloteau ◽

Thierry Lobbedez ◽

Sonia Guillouët ◽

Christian Verger ◽

Maxence Ficheux ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Lower Risk ◽

Regression Models ◽

Cox Regression ◽

French Language ◽

Dialysis Modality ◽

Technique Survival ◽

Hazard Ratios ◽

Effect Of Pd ◽

Assisted Peritoneal Dialysis

Background: Patients on peritoneal dialysis (PD) can be assisted by a nurse or a family member and treated either by automated PD (APD) or continuous ambulatory PD (CAPD). The aim of this study was to evaluate the effect of PD modality and type of assistance on the risk of transfer to haemodialysis (HD) and on the peritonitis risk in assisted PD patients. Method: This was a retrospective study based on data from the French Language PD Registry. All adults starting assisted PD in France between 2006 and 2015 were included. Events of interest were transfer to HD, peritonitis and death. Cox regression models were used for statistical analysis. Results: Among the 12,144 incident patients who started PD in France during the study period, 6,167 were assisted. There were 5,060 nurse-assisted and 1,095 family-assisted PD patients. Overall, 5,171 were treated by CAPD and 996 by APD. In multivariate analysis, CAPD, compared to APD, was not associated with the risk of transfer to HD (cause specific hazard ratios [cs-HR] 0.96 [95% CI 0.84–1.09]). Patients on nurse-assisted PD had a lower risk of transfer to HD than family assisted PD patients (cs-HR 0.85 [95% CI 0.75–0.97]). Neither PD modality nor type of assistance were associated with peritonitis risk. Conclusions: In assisted PD, technique survival was not associated with PD modality. Nurse-assisted patients had a lower risk of transfer to HD than family assisted patients. Peritonitis risk was not influenced either by PD modality, or by type of assistance. Both APD and CAPD should be offered to assisted-PD patients.

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Peritoneal dialysis after kidney transplant failure: a nationwide matched cohort study from the French Language Peritoneal Dialysis Registry (RDPLF)

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy290 ◽

2018 ◽

Vol 34 (5) ◽

pp. 858-863 ◽

Cited By ~ 2

Author(s):

Myriam Benomar ◽

Clement Vachey ◽

Thierry Lobbedez ◽

Julie Henriques ◽

Didier Ducloux ◽

...

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Kidney Transplant ◽

French Language ◽

Matched Cohort ◽

Matched Cohort Study ◽

Transplant Failure

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What do we learn about the “Anemia Module” of the French language Peritoneal Dialysis ? Interest and Results

Bulletin de la Dialyse à Domicile ◽

10.25796/bdd.v2i3.20983 ◽

2019 ◽

Vol 2 (3) ◽

pp. 143-149

Author(s):

Belkacem Issad ◽

Mireille Griuncelli ◽

Christian Verger ◽

Guy Rostoker

Keyword(s):

Peritoneal Dialysis ◽

Transferrin Saturation ◽

Intravenous Iron ◽

Therapeutic Benefit ◽

French Language ◽

Biological Assessment ◽

Erythropoiesis Stimulating Agents ◽

Treatment Practices ◽

Target Values ◽

Dialysis Vintage

Background: Anemia is commonly observed in patients with chronic kidney disease (CKD) as soon as the glomerular filtration rate falls below than 30 ml/min. CKD patients frequently have iron deficiency. The use of both erythropoiesis-stimulating agents (ESA) and iron therapy is the backbone of anemia management in CKD. For this reason, an adequate iron supply is mandatory to achieve the optimal therapeutic benefit of erythropoiesis stimulating agents (ESAs). Many groups agree that anemia in peritoneal dialysis (PD) patients is less severe than in hemodialysis (HD) patients and that there are important differences in treatment practices for anemia between PD and HD patients. Methods: Analysis of the Anemia module of the French Language Peritoneal Dialysis Registry (RDPLF) register from the database set up in 2005 with a study of the period 2010-2017. Results: Data from 568 patients who participated in the Anemia module were analysed during the 2010-2017 follow-up period. Their median age were 71 years, 42% were female, median dialysis vintage was 13 months, 40,5% of patients had diabetes mellitus, 74% of patients were treated with ESA, 23% were on oral iron and only 11% have received intravenous iron. In terms of biological assessment, the average hemoglobin level was close to 12 g/dl and median CRP was close to 5 mg/l. For the iron balance, ferritin reached an average level of 270 µg/l in 2013 and stabilized in 2017 at 200 µg/l. The transferrin saturation coefficient always fluctuated between 23 % and 25 % from year 2010 to year 2017. Conclusion: The results of the Anemia module of RDPLF register appear to be in line with the target values of the ERA-EDTA latest European guideline on anemia (ERBP 2013) and show the low use of intravenous iron in PD (usually as second line therapy).

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