Author(s): Plantinga LC, Fink NE, Finkelstein FO, Powe NR, Jaar BG
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Abstract OBJECTIVE: Very few studies have addressed the relationship between number of peritoneal dialysis (PD) patients treated at a clinic (PD clinic size) and clinical outcomes. In a national prospective cohort study of incident PD patients (n = 236, from 26 clinics), we examined whether being treated at a larger PD clinic [>50 PD patients (n = 3 clinics) vs 50 patients was associated with fewer switches to hemodialysis (RH = 0.13, 95\% CI 0.06 - 0.31) and fewer cardiovascular events (RH = 0.62, 95\% CI 0.06 - 0.98). No associations of PD clinic size with cardiovascular or all-cause mortality were seen. CONCLUSION: PD patients treated at clinics with greater numbers of PD patients may have better outcomes in terms of technique failure and cardiovascular morbidity. PD clinic size may act as a proxy of greater PD experience, more focus on the modality, and better PD practices at the clinic, resulting in better outcomes.
This article was published in Perit Dial Int and referenced in Internal Medicine: Open Access