Differences in hospitalisation between peritoneal dialysis and haemodialysis patients

Anita van Eck van der Sluijs, Anna A. Bonenkamp, the DOMESTICO study group, Vera A. van Wallene, Tiny Hoekstra, Birgit I. Lissenberg-Witte, Friedo W. Dekker, Frans J. van Ittersum, Marianne C. Verhaar, Brigit C. van Jaarsveld, Alferso C. Abrahams*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Original languageEnglish
Article numbere13758
JournalEuropean Journal of Clinical Investigation
Volume52
Issue number6
DOIs
Publication statusPublished - Jun 2022

Bibliographical note

Funding Information:
The retrospective part of the ‘Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes’ is supported by a grant of the Dutch Kidney Foundation (Grant no: A2D4P02). The sponsor had no role in the design and conduct of the study and no role in writing or in the decision to publish this paper.

Publisher Copyright:
© 2022 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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