title: Patient outcome in primary peritoneal dialysis patients versus those transferred from hemodialysis and transplantation.
abstract: BACKGROUND
  According to the concept of integrated care, renal transplantation, peritoneal dialysis (PD), and hemodialysis (HD) should be considered three complementary methods of renal replacement therapy. This study tried to evaluate patient outcomes in three different groups of PD patients, namely primary PD patients, those transferred to PD with failing kidney transplant, and those transferred to PD from HD.
  
  
  METHODS
  From January 1, 1995, to end of 2006 from 26 PD centers, 1,355 patients including demographic, clinical and laboratory data, which were monthly collected through questionnaires, were enrolled in the study. We compared patients' characteristics, factors affecting patient survival, and patient outcomes between primary PD patients (group 1, n = 1,067), patients transferred from transplantation (group 2, n = 43) and those transferred from HD (group 3, n = 245), which had been on HD for at least 3 months before switching to PD.
  
  
  RESULTS
  There was no difference in the proportion of patients with diabetes in the three groups. Overall, 238 patients (17.5%) were transferred to HD but there was no significant difference in PD technique survival on between the three groups. Death occurred in 256 (24%), 3 (7%) and 65 (26.5%) subjects in groups 1, 2 and 3, respectively. Most patients (81.5%) in group 2 underwent re-transplantation. The Kaplan-Meier survival rates were not different between the three groups. In the Cox multiple regression model, age, presence of diabetes and serum albumin level significantly influenced patient survival.
  
  
  CONCLUSIONS
  We concluded that PD could be considered safe for patients experiencing complications on HD, as well as for those with renal transplantation.
authors.affiliation: Nephrology Department of Shariati Hospital and Shafa Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Iraj
authors.initials: I
authors.lastname: Najafi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Hosseini
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Atabac
authors.forename: Hushang
authors.initials: H
authors.lastname: Sanadgol
authors.forename: Nader Nouri
authors.initials: NN
authors.lastname: Majelan
authors.forename: Shiva
authors.initials: S
authors.lastname: Seirafian
authors.forename: Massih
authors.initials: M
authors.lastname: Naghibi
authors.forename: Khadigeh
authors.initials: K
authors.lastname: Makhdoumi
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Saddadi
authors.forename: Tayebeh
authors.initials: T
authors.lastname: Soleymanian
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D010530:Peritoneal Dialysis / Q000379:methods* / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
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