Examine the Epidemiology and Outcomes of Transitions From PD-to-HD in Canada

N/AActive Not RecruitingNCT07477210

Ciusss de L'Est de l'Île de Montréal17,000 enrolled

Overview

Transitions from peritoneal dialysis to hemodialysis are common during kidney replacement therapy and may be associated with adverse outcomes. However, the incidence, predictors, and outcomes of PD-to-HD transitions at a national level remain incompletely characterized. This study will use Canadian dialysis and hospitalization databases to examine the epidemiology and outcomes of PD-to-HD transitions among adults initiating dialysis in Canada. The study will evaluate transition incidence, predictors, and post-transition outcomes including mortality, transplantation, modality changes, and hospitalizations.

Study Type

OBSERVATIONAL

Enrollment

17,000

Conditions

Peritoneal Dialysis (PD)Hemodialysis Kidney Replacement Therapy

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults (≥18 years) * Dialysis initiation in Canada between January 1, 2005 and December 31, 2018 * Peritoneal dialysis duration \>30 consecutive days Exclusion Criteria: * Dialysis initiation in Quebec or Manitoba during the study period * Dialysis initiation in a foreign country * Missing data on initial dialysis modality * Pre-emptive kidney transplantation

Locations (1)

Outcomes

Primary Outcomes

Incidence of transfer from peritoneal dialysis to hemodialysis

Measured as cumulative incidence and incidence rate of transitions following initiation of PD and censored at time of death, kidney transplantation, transfer home hemodialysis, or administrative end of follow-up.

Time frame: From PD initiation until 1-year after PD start Also assessed at from PD initation until 2- and 5-year after PD start.

Secondary Outcomes

All-cause mortality after transfer from peritoneal dialysis to hemodialysis

Censored for kidney transplantation, transfer home hemodialysis, return to PD or administrative end of follow-up December 31st, 2018

Time frame: From first day after transfer up to 1-year post transfert. Also assessed ad 2- and 5-year post transfer

Return to Peritoneal Dialysis

Defined as ≥1 consecutive day of peritoneal dialysis after transition and censored at time of death, kidney transplantation, transfer home hemodialysis or administrative end of follow-up December 31st, 2018)

Time frame: From first day after transfer to HD up to 180-day post transfer. Also measured at 90- and 365-day post transfer.

Transfer to Home Hemodialysis

Defined as ≥30 consecutive days of home hemodialysis censored at time of death, kidney transplantation, return to PD or administrative end of follow-up December 31st, 2018)

Time frame: From first day after transfer to HD until 180-day post transfer. Also measured at 90- and 365-day post transfer