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Dialysis outcomes in Colombia (DOC) study: A comparison of patient survival on peritoneal dialysis vs hemodialysis in Colombia

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dc.creatorSanabria, M.spa
dc.creatorMuñoz, J.spa
dc.creatorTrillos Peña, Carlos Enriquespa
dc.creatorHernández, G.spa
dc.creatorLatorre Santos, Catalinaspa
dc.creatorDíaz, C.S.spa
dc.creatorMurad, S.spa
dc.creatorRodríguez, K.spa
dc.creatorRivera, Áspa
dc.creatorAmador, A.spa
dc.creatorArdila, F.spa
dc.creatorCaicedo, A.spa
dc.creatorCamargo, D.spa
dc.creatorDíaz, A.spa
dc.creatorGonzález, J.spa
dc.creatorLeguizamón, H.spa
dc.creatorLopera, P.spa
dc.creatorMarín, L.spa
dc.creatorNieto, I.spa
dc.creatorVargas, E.spa
dc.date.accessioned2020-05-25T23:56:44Z
dc.date.available2020-05-25T23:56:44Z
dc.date.created2008spa
dc.description.abstractThe goal of the Dialysis Outcomes in Colombia (DOC) study was to compare the survival of patients on hemodialysis (HD) vs peritoneal dialysis (PD) in a network of renal units in Colombia. The DOC study examined a historical cohort of incident patients starting dialysis therapy between 1 January 2001 and 1 December 2003 and followed until 1 December 2005, measuring demographic, socioeconomic, and clinical variables. Only patients older than 18 years were included. As-treated and intention-to-treat statistical analyses were performed using the Kaplan-Meier method and Cox proportional hazard model. There were 1094 eligible patients in total and 923 were actually enrolled: 47.3% started HD therapy and 52.7% started PD therapy. Of the patients studied, 751 (81.3%) remained in their initial therapy until the end of the follow-up period, death, or censorship. Age, sex, weight, height, body mass index, creatinine, calcium, and Subjective Global Assessment (SGA) variables did not show statistically significant differences between the two treatment groups. Diabetes, socioeconomic level, educational level, phosphorus, Charlson Co-morbidity Index, and cardiovascular history did show a difference, and were less favorable for patients on PD. Residual renal function was greater for PD patients. Also, there were differences in the median survival time between groups: 27.2 months for PD vs 23.1 months for HD (P less than 0.001) by the intention-to-treat approach; and 24.5 months for PD vs 16.7 months for HD (P less than 0.001) by the as-treated approach. When performing univariate Cox analyses using the intention-to-treat approach, associations were with age ?65 years (hazard ratio (HR)=2.21; confidence interval (CI) 95% (1.77-2.755); P less than 0.001); history of cardiovascular disease (HR=1.96; CI 95% (1.58-2.90); P less than 0.001); diabetes (HR=2.34; CI 95% (1.88-2.90); P less than 0.001); and SGA (mild or moderate-severe malnutrition) (HR=1.47; CI 95% (1.17-1.79); P=0.001); but no association was found with gender (HR=1.03, CI 95% 0.83-1.27; P=0.786). Similar results were found with the as-treated approach, with additional associations found with Charlson Index (0-2) (HR=0.29; Cl 95% (0.22-0.38); P less than 0.001); Charlson Index (3-4) (HR=0.61; Cl 95% (0.48-0.79); P less than 0.001); and SGA (mild-severe malnutrition) (HR=1.43; Cl 95% (1.15-1.77); P less than 0.001). Similarly, the multivariate Cox model was run with the variables that had shown association in previous analyses, and it was found that the variables explaining the survival of patients with end-stage renal disease in our study were age, SGA, Charlson Comorbidity Index 5 and above, diabetes, healthcare regimes I and II, and socioeconomic level 2. The results of Cox proportional risk model in both the as-treated and intention-to-treat analyses showed that there were no statistically significant differences in survival of PD and HD patients: intention-to-treat HD/PD (HR 1.127; CI 95%: 0.855-1.484) and as-treated HD/PD (HR 1.231; CI 95%: 0.976-1.553). In this historical cohort of incident patients, there was a trend, although not statistically significant, for a higher (12.7%) adjusted mortality risk associated with HD when compared to PD, even though the PD patients were poorer, were more likely to be diabetic, and had higher co-morbidity scores than the HD patients. The variables that most influenced survival were age, diabetes, comorbidity, healthcare regime, socioeconomic level, nutrition, and education. © 2008 International Society of Nephrology.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1038/sj.ki.5002619
dc.identifier.issn00852538
dc.identifier.issn15231755
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/22502
dc.language.isoengspa
dc.publisherNature Publishing Groupspa
dc.relation.citationEndPageS172
dc.relation.citationIssueNo. SUPPL. 108
dc.relation.citationStartPageS165
dc.relation.citationTitleKidney International
dc.relation.citationVolumeVol. 73
dc.relation.ispartofKidney International, ISSN:00852538, 15231755, Vol.73, No.SUPPL. 108 (2008); pp. S165-S172spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-44449095268&doi=10.1038%2fsj.ki.5002619&partnerID=40&md5=bdd523c35c06d1f1e4e7ed41408dff04spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordAdultspa
dc.subject.keywordcontinuous ambulatoryeng
dc.subject.keywordAge distributionspa
dc.subject.keywordchroniceng
dc.subject.keywordAgedspa
dc.subject.keywordArticlespa
dc.subject.keywordCardiovascular diseasespa
dc.subject.keywordColombiaspa
dc.subject.keywordComorbidityspa
dc.subject.keywordControlled studyspa
dc.subject.keywordDiabetes mellitusspa
dc.subject.keywordDisease severityspa
dc.subject.keywordFemalespa
dc.subject.keywordHemodialysisspa
dc.subject.keywordHemodialysis patientspa
dc.subject.keywordHumanspa
dc.subject.keywordIntermethod comparisonspa
dc.subject.keywordKidney functionspa
dc.subject.keywordMajor clinical studyspa
dc.subject.keywordMalespa
dc.subject.keywordMortalityspa
dc.subject.keywordPatient educationspa
dc.subject.keywordPeritoneal dialysisspa
dc.subject.keywordPhosphate blood levelspa
dc.subject.keywordPriority journalspa
dc.subject.keywordSmall for date infantspa
dc.subject.keywordSocioeconomicsspa
dc.subject.keywordSurvivalspa
dc.subject.keywordAdolescentspa
dc.subject.keywordBloodspa
dc.subject.keywordChronic kidney failurespa
dc.subject.keywordClinical trialspa
dc.subject.keywordComparative studyspa
dc.subject.keywordContinuous ambulatory peritoneal dialysisspa
dc.subject.keywordDiabetes mellitusspa
dc.subject.keywordFollow upspa
dc.subject.keywordKaplan meier methodspa
dc.subject.keywordMethodologyspa
dc.subject.keywordMiddle agedspa
dc.subject.keywordMulticenter studyspa
dc.subject.keywordProportional hazards modelspa
dc.subject.keywordTreatment outcomespa
dc.subject.keywordPhosphorusspa
dc.subject.keywordAdolescentspa
dc.subject.keywordAdultspa
dc.subject.keywordAgedspa
dc.subject.keywordAged, 80 and overspa
dc.subject.keywordColombiaspa
dc.subject.keywordDiabetes complicationsspa
dc.subject.keywordFemalespa
dc.subject.keywordFollow-up studiesspa
dc.subject.keywordHumansspa
dc.subject.keywordKaplan-meiers estimatespa
dc.subject.keywordKidney failureeng
dc.subject.keywordMalespa
dc.subject.keywordMiddle agedspa
dc.subject.keywordPeritoneal dialysisspa
dc.subject.keywordPeritoneal dialysiseng
dc.subject.keywordPhosphorusspa
dc.subject.keywordProportional hazards modelsspa
dc.subject.keywordSocioeconomic factorsspa
dc.subject.keywordTreatment outcomespa
dc.subject.keywordColombiaspa
dc.subject.keywordDialysisspa
dc.subject.keywordHemodialysisspa
dc.subject.keywordMortalityspa
dc.subject.keywordOutcomespa
dc.subject.keywordPeritoneal dialysisspa
dc.subject.keywordSurvivalspa
dc.titleDialysis outcomes in Colombia (DOC) study: A comparison of patient survival on peritoneal dialysis vs hemodialysis in Colombiaspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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