WEDNESDAY, Feb. 26, 2025 (HealthDay News) — Nurse assistance is associated with a lower risk for transfer from peritoneal dialysis (PD) to hemodialysis (HD) for infection in the first 18 months and for adequacy issues after six months, according to a study published online Feb. 7 in Kidney360.
Nanti E. Adoukonou, from Centre François Baclesse in Caen, France, and colleagues compared the risks for the different reasons for transfer to HD in PD patients according to use of assistance for PD care, PD modality, and suboptimal starter status in a retrospective study. The study included 15,974 PD patients from 170 PD units who started treatment between Jan. 1, 2002, and Dec. 31, 2018.
The researchers identified 6,835 deaths, 5,108 transfers to HD, and 3,092 renal transplantations. Nurse-assisted PD was associated with a reduced risk for transfer to HD for infection in the first 18 months and for adequacy issues after six months (cause-specific hazard ratio [HR], 0.51; 95 percent confidence interval [CI], 0.31 to 0.83 [before six months] and HR, 0.59; 95 percent CI, 0.51 to 0.70 [beyond 18 months]). A higher risk for transfer for mechanical issue was seen for continuous ambulatory PD (CAPD) than automated PD during the first 18 months (HR, 1.41; 95 percent CI, 1.00 to 1.99 [before six months]), but lower risks for adequacy, infectious, or mechanical issues were seen in association with CAPD after 18 months. A higher risk for transfer due to psychosocial challenges was seen with suboptimal starters in the first six months (HR, 1.70; 95 percent CI, 1.03 to 2.81).
“Recognizing these risk factors could help target specific patients with tailored preventive measures to reduce the risk of transfer for each particular cause,” the authors write. “Further studies would be needed to explore the effect of such measures.”
Several authors disclosed ties to the pharmaceutical industry.
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