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Survival for haemodialysis vs. peritoneal dialysis and technique transference. Experience in Ourense, Spain, from 1976 to 2012
Supervivencia en hemodiálisis vs. diálisis peritoneal y por transferencia de técnica. Experiencia en Ourense 1976–2012
Alfonso Otero González
, Alfonso Iglesias Forneiro, María Jesús Camba Caride, Cristina Pérez Melón, María Paz Borrajo Prol, Enrique Novoa Fernández, Ivan Gilberto Arenas Moncaleano, Silvia Uribe Moya, Fiz Lagoa Labrador
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Servicio de Nefrología, Complexo Hospitalario Universitario de Ourense, Ourense , Spain
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Experience in Ourense, Spain, from 1976 to 2012" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "562" "paginaFinal" => "566" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alfonso Otero González, Alfonso Iglesias Forneiro, María Jesús Camba Caride, Cristina Pérez Melón, María Paz Borrajo Prol, Enrique Novoa Fernández, Ivan Gilberto Arenas Moncaleano, Silvia Uribe Moya, Fiz Lagoa Labrador" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Alfonso" "apellidos" => "Otero González" "email" => array:1 [ 0 => "alfonso.otero.gonzalez@sergas.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alfonso" "apellidos" => "Iglesias Forneiro" ] 2 => array:2 [ "nombre" => "María Jesús" "apellidos" => "Camba Caride" ] 3 => array:2 [ "nombre" => "Cristina" "apellidos" => "Pérez Melón" ] 4 => array:2 [ "nombre" => "María Paz" "apellidos" => "Borrajo Prol" ] 5 => array:2 [ "nombre" => "Enrique" "apellidos" => "Novoa Fernández" ] 6 => array:2 [ "nombre" => "Ivan Gilberto" "apellidos" => "Arenas Moncaleano" ] 7 => array:2 [ "nombre" => "Silvia" "apellidos" => "Uribe Moya" ] 8 => array:2 [ "nombre" => "Fiz" "apellidos" => "Lagoa Labrador" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Nefrología, Complexo Hospitalario Universitario de Ourense, Ourense , Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Supervivencia en hemodiálisis vs. diálisis peritoneal y por transferencia de técnica. Experiencia en Ourense 1976–2012" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1442 "Ancho" => 3180 "Tamanyo" => 158819 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">(A) Overall survival in HD vs. PD. (B) Comparison of survival between incident HD vs. PD followed for less than 6 months.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The survival of uraemic patients on haemodialysis (HD) and peritoneal dialysis (PD) was compared in several trials over recent years, resulting in extended controversy and dissimilar outcomes.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> The reasons accounting for this variability are complex, but are basically associated with the use of different study designs including non-homogeneous populations, different types of follow-up, the analysis of incident vs. prevalent population, and comorbidities prior to renal replacement therapy (RRT).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A number of studies have shown that pre-RRT comorbidities are the most important factors predicting survival.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2,3</span></a> Therefore, the dialysis modality may not have an independent effect on survival; furthermore, studies should be conducted on the incident patients.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Since the beginning of the century it was suggested that both types of replacement therapy should be considered complementary for the “integral care” of the patient, an approach that may improve the survival in RRT.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> This is based on the idea that RRT should be started with PD and then switched to HD in case of complications or “lack of efficiency” of the technique.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">6,7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Based on these premises, our aim is to assess survival in both, HD vs. PD as well as survival resulting from the switch from PD to HD in patients from a retrospective cohort of 36-year of data collection.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">The study includes a retrospective cohort of patients receiving RRT in our centre between 1976 and 2012. This registry includes data on demographics (age, sex, background disease) change of replacement therapy, transplants, deaths, or change of address. The original population were 1231 patients; but 223 were excluded because of incomplete data ondemographics; the final study sample was 993 patients.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Statistics: Gaussian variables and non-Gaussian variables will be presented as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD and as medians, respectively. Variables were tested for normality using the Kolmogorov–Smirnov and Shapiro–Wilk tests. Qualitative variables will be expressed as frequencies and percentages.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Data were “censored” for transplants, loss or change of technique, or death.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The survival analysis by dialysis modality was performed from day 0 and was stratified by age, with the sample median as the cut-off value: 65 years of age, sex, and presence or absence of diabetes mellitus (DM).</p><p id="par0045" class="elsevierStylePara elsevierViewall">Overall survival was estimated in the cohort and in strata defined by Kaplan–Meier. The relative risks of mortality for PD vs. HD were assessed by using a Cox regression analysis. Technique transference was analysed using Kaplan–Meier in patients who had completed over 12 weeks.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Differences were considered statistically significant at a <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 in all analyses. Analyses were made by using the R free software (<a href="http://www.r-project.org/">http://www.r-project.org</a>).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">A total of 993 patients were included in the cohort (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Elderly patients tended to be started with HD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0374) and the incidence of DM was higher in PD patients (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.000).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The reason to cease the data collection were: a change in techniques: 91 (9.16%); death: 488 (49.14%); transplant: 271 (27.29%); loss to follow-up: 25 (2.52%); and continued PD: 29 (2.92%) and HD: 89 (8.96%).</p><p id="par0065" class="elsevierStylePara elsevierViewall">Survival was lower in patients who started with PD <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a). Median survival time was 1815 days (4.97 years) in HD and 1255 days (3.44 years) in PD. Cumulative mortality was 52.12% in the HD group and 42.53% in the PD group (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The survival in consecutive incidents patients in HD (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>548) vs. PD (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>244) in less than 6 months favoured PD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0091) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). The median survival time in patients starting HD and PD were was 138 days and 173 respectively. The cumulative mortality in HD patients was 55.95% and 31.67% in PD patients (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01).</p><p id="par0075" class="elsevierStylePara elsevierViewall">No differences in survival were found in patients followed for less than a year (HD, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>452 and PD, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>195) (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.1277), 5 years (HD, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>149 and PD, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>29) (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.4287), or 10 years (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.1057).</p><p id="par0080" class="elsevierStylePara elsevierViewall">When corrected by age, the overall survival was slightly lower in the PD group. No difference in survival was found among patients older than 65 years (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.068). Median survival in HD and PD was 1340 days (3.67 years) and 926 days (2.53 years), respectively. Cumulative mortality in HD and PD was 69.04% and 70.23%, respectively (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8034). No differences were observed in patients who were 65 years of age or younger (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.2249), although cumulative mortality was 37.02 in HD and 22.03 in PD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p><p id="par0085" class="elsevierStylePara elsevierViewall">In relation to gender, survival is higher for incident males in HD as compared to males starting on PD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0064). Median survival in HD was 1741 days (4.77 years) and 1112 days in PD (3.04 years), while cumulative mortality in HD was 50.9% and 43.62% in men from the PD group (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0939). No significant differences were observed among women with the two types of treatment (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.5249); however the cumulative mortality was 54.39% and 40.83% in HD and PD patients, respectively (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0090" class="elsevierStylePara elsevierViewall">Overall survival was superior in non-diabetic vs. diabetic patients (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). Median survival in HD was 1910 days (5.23 years) and 1465 days (4 years) in PD. Cumulative mortality was 50.09% in HD and 36.74% in PD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). No significant differences were observed among incident diabetic patients based on dialysis technique (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.3606). Median time on HD was 1161 days (3.19 years) and 1000 days (2.74 years) in PD. Cumulative mortality in the HD and PD groups were 65.66% and 56.67% (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.2049) respectively. No differences were found in non-diabetic patients in HD vs. PD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.1489).</p><p id="par0095" class="elsevierStylePara elsevierViewall">The mortality risk adjusted for age, gender, technique, and diabetes (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) shows a 4.8% yearly increase in the estimated risk of death (HR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.048, 95% CI, 1.04–1.06, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001) and there is 44% increase in diabetic vs. non-diabetic patients (HR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.44, 95% CI, 1.16–1.76, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01). The analysis of the impact of changing technique (PD to HD) was conducted in 654 subjects who started with HD (who were not transferred) and 57 subjects who had started with PD and later there were switched to HD. Survival rates of incident patients in HD and PD who were switched to HD are shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Patients starting on HD have a lower survival rate than patients who initiated PD and then switched to HD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0563). The median survival time of patients starting with HD was 1742 days (4.77 years) and 2566 days (7.02 years) in patients starting with PD who switched to HD.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Cumulative mortality was 54.59% in HD patients and 50.85% (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.5808, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05) in PD patients who were switched to HD.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The analysis of survival in incident patients who were followed for at least 5 years between HD and PD who were switched was not significant (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.1767), and neither was the cumulative mortality (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.7096<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05). However, significant differences were observed in patients followed for 10, 15, and 20 years.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Patients starting with HD had a worse 10-year survival (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01) as compared to patients starting with PD who were switched to HD. The median survival time in HD was 1621 days (4.44 years) and 2533 days (6.93 years) in patients starting with PD who were later switched to HD.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Cumulative mortality in HD patients was 303/506 (53.53%) and 28/55 (50.91%) (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.7096) in patients who started with PD and switched to HD.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The 15-year survival is also worse in HD patients compared to patients who started with PD and switched to HD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05). The median survival time in patients starting with HD was 1714 days (4.69 years) and 2566 days (7.02 years) in patients who started with PD and switched to HD. Cumulative mortality in HD patients was 314/587 (53.49%) and 19/56 (51.79%) in patients who started with PD and switched to HD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8068).</p><p id="par0130" class="elsevierStylePara elsevierViewall">Significant differences were still present at 20 years (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.005). The median survival in patients starting on HD was 1727 days (4.73 years) and 2566 days (7.02 years) in patients who started with PD and were switched to HD. Cumulative mortality in the HD group was 320/595 (53.78%) and 30/57 (52.63%) in patients who started with PD and were switched to HD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8679).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0135" class="elsevierStylePara elsevierViewall">As a result of the methods used, survival studies on RRT posed major challenges, complications, and diverse interpretations. As first explained in the Ross et al. meta-analysis,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> the most important factor having an effect on survival is previous history of comorbidities, while dialysis technique has no independent and differentiated effect. Under these circumstances, the strategy of the statistical analysis should have a major effect in the final outcome. By means of a refined description, Perez Fontan et al.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> address problems arising in this type of analysis, essentially including: statistical methods used, and external and internal validity of studies. In our case, just as in any other study, the statistical methods used<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> were the univariate analysis of actuarial survival and Kaplan–Meier, and the Cox multivariate analysis. Even though the latter has certain limitations, including assumed linearity (the effect of RRT may not be consistent over time) and the consideration of a single terminal event. As far as limitations resulting from internal validity, cardiovascular and non-cardiovascular comorbidity of patients is not available, and of course, allocation of treatment modality is not at random. A comparison of the baseline characteristics of the sample (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) revealed that the PD population was younger (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.03749) and the prevalence of DM was higher (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0000), and our results are consistent with other studies,<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2,4,8,9</span></a> where survival is influenced by age and DM, and this effect is sustained following the adjustment for comorbidities.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Survival was higher in PD that HD at 6 months, just as in other observations,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> but no significant differences were seen at 5 and 10 years, as described.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">9–11</span></a> This outcome is certainly influenced by technical improvements both in PD and HD, early remission in patients in the end-stage chronic renal disease (ESCRD) consultation and free choice of therapy.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1,8,9</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The change from PD to HD results in a higher survival rate<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> and in our case survival was higher in PD patients who were transferred to HD as compared to those who remained in HD, thereby strengthening the notion of “integrated care” in RRT. RRT should be started with PD and then switched to HD once completed or in case of loss of residual renal function.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5–7</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The study had two basic limitations. The first limitation is that it is a retrospective and that the patient allocation is not at random, and the second limitation is that no data were collected on comorbidity, except for age and concurrent DM, or variables including dialysis dosing, HD or PD modality, residual renal function or arteriovenous fistula or catheter. Nonetheless, an analysis of a database including information from a 32-year follow-up proves that survival in RRT is higher when patients start with PD and are later switched to HD, and that mortality risk is 2.6-fold higher in patients older than 65 years and is increased by 50% in patients with diabetes mellitus.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres818370" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec815399" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres818371" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Material y métodos" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec815400" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-12-23" "fechaAceptado" => "2015-03-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec815399" "palabras" => array:2 [ 0 => "Survival on dialysis" 1 => "Peritoneal dialysis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec815400" "palabras" => array:2 [ 0 => "Supervivencia en diálisis" 1 => "Diálisis peritoneal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess SV in our RRT population in the period 1976–2012 as well as the influence of technique transference (TT).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The study included a retrospective cohort of 993 patients. Data were classified as transplant (Tx), change in technique, exitus or lost to follow-up. SV for TT was determined in patients with over 12 weeks of permanence.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mortality risk adjusted for age, sex, dialysis technique or diabetes mellitus (DM) showed that the estimated risk of death increased by 4.8% per year increase (HR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.048; 95% CI: 1.04–1.06; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001) and was 44% higher in diabetics compared to non-diabetics (HR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.44; 95% CI 1.16–1.76; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.01). Regarding SV for TT, patients who initiated HD had a shorter survival than those who initiated PD and transferred to HD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.00563).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In our experience, SV in RRT is dependent on age and coexistence of DM. It would be beneficial to reinstate the concept of “comprehensive care”, in which RRT would start with PD and later transfer to HD.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La supervivencia (SV) comparada en terapia renal sustitutiva (TRS) es dependiente de la comorbilidad previa al inicio de TRS y no de la técnica dialítica.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Valorar la SV en nuestra población de TRS habida en el periodo 1976–2012 y asimismo la influencia por la transferencia de técnica (TTc).</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Material y métodos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Cohorte retrospectiva (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>993 pacientes). Los datos fueron “censurados” por trasplante (TX), cambio de técnica, defunción o pérdida para el seguimiento. La SV por TTc se realizó en pacientes con más de 12 semanas de permanencia.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El riesgo de mortalidad ajustado por edad, sexo, técnica dialítica o diabetes mellitus (DM) mostró que el riesgo estimado de morir aumenta un 4,8% por cada año aumentado (HR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1048, IC del 95%, 1,04–1,06, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001) y este aumenta un 44% en los diabéticos con respecto a los no diabéticos (HR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1,44, IC del 95%, 1,16–1,76, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,01). En cuanto a la SV por TTc, los que inician HD presentan SV menor que los que inician DP y son transferidos a HD (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,00563).</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusión</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En nuestra experiencia, la SV en TRS es dependiente de la edad y la coexistencia de DM y sería conveniente retomar el concepto de “cuidados integrales” comenzado la TRS por DP y transferir a HD.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Material y métodos" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Otero González A, Iglesias Forneiro A, Camba Caride MJ, Pérez Melón C, Borrajo Prol MP, Novoa Fernández E, et al. Supervivencia en hemodiálisis vs. diálisis peritoneal y por transferencia de técnica. Experiencia en Ourense 1976–2012. Nefrología. 2015;35:562–566.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1442 "Ancho" => 3180 "Tamanyo" => 158819 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">(A) Overall survival in HD vs. PD. (B) Comparison of survival between incident HD vs. PD followed for less than 6 months.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1468 "Ancho" => 1652 "Tamanyo" => 84484 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">SV incidents compared between HD and PD patients transferred HD. SV: actuarial survival; HD: hemodialysis; DP: peritoneal dialysis.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">HD, haemodialysis; LFU, lost to follow-up; PD, peritoneal dialysis; Tx, treatment.</p>" "tablatextoimagen" => array:3 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Men \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">634 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.85 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Women \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">359 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">794 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.77 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">189 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">685 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.98 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">PD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">308 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375532.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HD (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>685) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PD (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>308) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age (M<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.97<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16.74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0374 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gender (male) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">446 (65.11%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">188 (61.04%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.2168 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Diabetes (yes) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">99 (14.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90 (29.51%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0000 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375529.png" ] ] 2 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome</th></tr><tr title="table-row"><th class="td" title="table-head " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">HD</span>, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">685</span></th><th class="td" title="table-head " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">PD</span>, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">308</span></th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">357 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.12% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">131 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.53% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">89 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.99% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.42% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tx \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">188 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.44% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Tx \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.95% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Switch to PD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.53% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Switch to HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.48% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LFU \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.92% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LFU \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.62% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375530.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Descriptive analysis of the cohort and outcome.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Coefficients \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SE \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> Value \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI for HR \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age (year) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0469 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0040 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.0480 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.04–1.06) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gender (male) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.1884 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.1009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0620 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.2073 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(0.99–1.47) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Technique (PD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.2190 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.1076 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0418 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.2449 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.01–1.54) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Diabetes (yes) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.3646 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.1114 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.4399 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.16–1.79) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375531.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Adjusted mortality risk.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Análisis crítico de los estudios de supervivencia en diálisis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Remon" 1 => "P.L. Quiros" 2 => "J. Portoles" 3 => "B. Marron" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2010" "volumen" => "1" "numero" => "Suppl. 1" "paginaInicial" => "8" "paginaFinal" => "14" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0065" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determinantes precoces de supervivencia en hemodiálisis hospitalaria y diálisis peritoneal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Perez Fontan" 1 => "A. Rodriguez Carmona" 2 => "T. Garcia Falcon" 3 => "C. Tresancos" 4 => "C. Fernandez Rivera" 5 => "F. Valdes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nefrologia" "fecha" => "1999" "volumen" => "XIX" "paginaInicial" => "1.62" "paginaFinal" => "1.69" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0070" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis of outcome studies in end-stage renal disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Ross" 1 => "E. Dong" 2 => "M. Gordon" 3 => "I. Connelly" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "2000" "volumen" => "57" "numero" => "Suppl. 74" "paginaInicial" => "528" "paginaFinal" => "538" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0075" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mortality in end-stage renal disease: a reassessment of differences between patients treated with hemodialysis and peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.F. Vonesh" 1 => "J. Moran" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "1999" "volumen" => "10" "paginaInicial" => "354" "paginaFinal" => "356" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10215336" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1529943013018445" "estado" => "S300" "issn" => "15299430" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0080" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An evaluation of an integrative care approach for end stage renal disease patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W. Van Biesen" 1 => "R.C. Vanholder" 2 => "N. Veys" 3 => "A. Dhondt" 4 => "N.H. Lameire" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2000" "volumen" => "11" "paginaInicial" => "116" "paginaFinal" => "125" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10616847" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0085" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Integrated end – stage renal disease care: the role of peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.P. Blake" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Nephrol Dial Trasplant" "fecha" => "2001" "volumen" => "16" "numero" => "Suppl. 1" "paginaInicial" => "61" "paginaFinal" => "66" "itemHostRev" => array:3 [ "pii" => "S1529943015014539" "estado" => "S300" "issn" => "15299430" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0090" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reformulating the integrated care concept for the new millennium" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.C. Mendelssohn" 1 => "A. Pierratos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2002" "volumen" => "22" "paginaInicial" => "5" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11929144" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0095" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current peritoneal dialysis compared with haemodialysis: medium-term survival analysis of incident dialysis patients in the Canary Islands in recent years" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Rufino" 1 => "C. García" 2 => "N. Vega" 3 => "M. Macía" 4 => "D. Hernández" 5 => "A. Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2011.Jan.10743" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "174" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21461011" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0100" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Mehrotra" 1 => "Y.W. Chiu" 2 => "K. Kalantar-Zadeh" 3 => "J. Bargman" 4 => "E. Vonesh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archinternmed.2010.352" "Revista" => array:7 [ "tituloSerie" => "Arch Intern Med" "fecha" => "2011" "volumen" => "171" "paginaInicial" => "110" "paginaFinal" => "118" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20876398" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0967586815004270" "estado" => "S300" "issn" => "09675868" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0105" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Confounding effect of comorbidity in survival studies in patients on renal replacement therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.G. Van Manen" 1 => "P.C. van Dijk" 2 => "V.S. Stel" 3 => "F.W. Dekker" 4 => "M. Clèries" 5 => "F. Conte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfl502" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "2007" "volumen" => "22" "paginaInicial" => "187" "paginaFinal" => "195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16998216" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0110" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An update on renal replacement therapy in Europe: ERA-EDTA registry data from 1997 to 2006" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Kramer" 1 => "V. Stel" 2 => "C. Zoccali" 3 => "J. Heaf" 4 => "D. Ansell" 5 => "C. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 13 | 18 |
| 2024 October | 35 | 34 | 69 |
| 2024 September | 54 | 30 | 84 |
| 2024 August | 56 | 56 | 112 |
| 2024 July | 34 | 26 | 60 |
| 2024 June | 47 | 41 | 88 |
| 2024 May | 43 | 25 | 68 |
| 2024 April | 46 | 65 | 111 |
| 2024 March | 36 | 29 | 65 |
| 2024 February | 36 | 36 | 72 |
| 2024 January | 25 | 24 | 49 |
| 2023 December | 25 | 18 | 43 |
| 2023 November | 39 | 32 | 71 |
| 2023 October | 42 | 24 | 66 |
| 2023 September | 36 | 21 | 57 |
| 2023 August | 34 | 33 | 67 |
| 2023 July | 44 | 32 | 76 |
| 2023 June | 51 | 21 | 72 |
| 2023 May | 76 | 28 | 104 |
| 2023 April | 63 | 13 | 76 |
| 2023 March | 77 | 23 | 100 |
| 2023 February | 66 | 16 | 82 |
| 2023 January | 59 | 25 | 84 |
| 2022 December | 66 | 31 | 97 |
| 2022 November | 66 | 37 | 103 |
| 2022 October | 106 | 43 | 149 |
| 2022 September | 70 | 38 | 108 |
| 2022 August | 56 | 53 | 109 |
| 2022 July | 54 | 44 | 98 |
| 2022 June | 42 | 32 | 74 |
| 2022 May | 89 | 33 | 122 |
| 2022 April | 82 | 61 | 143 |
| 2022 March | 83 | 51 | 134 |
| 2022 February | 67 | 39 | 106 |
| 2022 January | 86 | 38 | 124 |
| 2021 December | 71 | 51 | 122 |
| 2021 November | 74 | 37 | 111 |
| 2021 October | 82 | 42 | 124 |
| 2021 September | 86 | 47 | 133 |
| 2021 August | 94 | 44 | 138 |
| 2021 July | 93 | 38 | 131 |
| 2021 June | 71 | 33 | 104 |
| 2021 May | 87 | 38 | 125 |
| 2021 April | 138 | 67 | 205 |
| 2021 March | 116 | 39 | 155 |
| 2021 February | 90 | 23 | 113 |
| 2021 January | 52 | 19 | 71 |
| 2020 December | 81 | 20 | 101 |
| 2020 November | 61 | 20 | 81 |
| 2020 October | 27 | 38 | 65 |
| 2020 September | 43 | 23 | 66 |
| 2020 August | 41 | 11 | 52 |
| 2020 July | 43 | 15 | 58 |
| 2020 June | 52 | 17 | 69 |
| 2020 May | 31 | 13 | 44 |
| 2020 April | 36 | 26 | 62 |
| 2020 March | 26 | 17 | 43 |
| 2020 February | 40 | 28 | 68 |
| 2020 January | 32 | 27 | 59 |
| 2019 December | 50 | 27 | 77 |
| 2019 November | 66 | 21 | 87 |
| 2019 October | 35 | 14 | 49 |
| 2019 September | 46 | 15 | 61 |
| 2019 August | 35 | 19 | 54 |
| 2019 July | 34 | 22 | 56 |
| 2019 June | 30 | 24 | 54 |
| 2019 May | 19 | 18 | 37 |
| 2019 April | 71 | 28 | 99 |
| 2019 March | 36 | 31 | 67 |
| 2019 February | 27 | 20 | 47 |
| 2019 January | 48 | 19 | 67 |
| 2018 December | 123 | 39 | 162 |
| 2018 November | 199 | 16 | 215 |
| 2018 October | 185 | 28 | 213 |
| 2018 September | 137 | 13 | 150 |
| 2018 August | 125 | 16 | 141 |
| 2018 July | 65 | 18 | 83 |
| 2018 June | 71 | 10 | 81 |
| 2018 May | 69 | 20 | 89 |
| 2018 April | 86 | 8 | 94 |
| 2018 March | 49 | 16 | 65 |
| 2018 February | 53 | 8 | 61 |
| 2018 January | 36 | 14 | 50 |
| 2017 December | 42 | 6 | 48 |
| 2017 November | 37 | 13 | 50 |
| 2017 October | 33 | 9 | 42 |
| 2017 September | 29 | 10 | 39 |
| 2017 August | 27 | 14 | 41 |
| 2017 July | 24 | 11 | 35 |
| 2017 June | 41 | 11 | 52 |
| 2017 May | 31 | 5 | 36 |
| 2017 April | 24 | 7 | 31 |
| 2017 March | 21 | 5 | 26 |
| 2017 February | 24 | 18 | 42 |
| 2017 January | 24 | 12 | 36 |
| 2016 December | 32 | 11 | 43 |
| 2016 November | 54 | 16 | 70 |
| 2016 October | 78 | 15 | 93 |
| 2016 September | 92 | 7 | 99 |
| 2016 August | 92 | 3 | 95 |
| 2016 July | 136 | 7 | 143 |
| 2016 June | 88 | 0 | 88 |
| 2016 May | 130 | 0 | 130 |
| 2016 April | 111 | 0 | 111 |
| 2016 March | 101 | 0 | 101 |
| 2016 February | 110 | 0 | 110 |
| 2016 January | 2 | 0 | 2 |
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