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Perit Dial Int 27(Supplement_3): 16- 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical Experience

Comparison of Patient Turnover/Loss in an Academic Hemodialysis Unit and Peritoneal Dialysis Unit

S. Moossavi, S. Moossavi, M. Coe and J. Burkart

Wake Forest, Winston Salem, North Carolina, USA

Objective: To compare total patient (pt) dropout rates [pt loss from transplant (Tx), death, transfer out, return of RRF, and loss to follow-up] per 100-pt per year in peritoneal dialysis (PD) and hemodialysis (HD). Methods: A retrospective observational cohort study using data collection from all adult pts at an academic out-pt dialysis unit (excluding the transient pts), from 1 January 2005 to 31 December 2006. Calculation of specific dropout or loss rates were done using the following formula: number of pts at risk = N1 + (1/2)*N2 – (1/2)*N3, where N1 = number of pts at beginning of year; N2 = number of new pts (= incident + transferred in) during the year; N3 = number of pts who leave for any reason during the year. Event rate per 100 pt year = 100*(number of events in year/number pts at risk). Results: On 1 January 2005: number of HD pts = 645. From 1 January 2005 to 31 December 2005: new pts: incident = 219, and transfer in (t-in) = 85. Pt loss: expired (exp) = 120, Tx = 18, regain function (re-f) = 6, transferred out (t-out) = 89, discontinue therapy (dc-t) = 14, and change treatment modality (ch-t) = 14. HD dropout rate = 39, HD Tx rate = 3, and HD death rate = 18. On 1 January 2005: number of PD pts = 161. From 1 January 2005 to 31 December 2005: new pts: incident = 46, and t-in = 35. Pt loss: exp = 23, Tx = 29, re-f = 4, t-out = 29, dc-t = 3, and ch-t = 6. PD dropout rate = 61, PD Tx rate = 19, and PD death rate = 15. On 1 January 2006: number of HD pts = 706. From 1 January 2006 to 31 December 2006: new pts: incident = 190, and t-in = 94. Pt loss: exp = 133, Tx = 27, re-f = 10, t-out = 124, dc-t = 20, and ch-t = 31. HD dropout rate = 51, HD Tx rate = 4, and HD death rate = 20. On 1 January 2006: number of PD pts = 169. From 1 January 2006 to 31 December 2006: new pts: incident = 44, and t-in = 47. Pt loss: exp = 33, Tx = 27, re-f = 1, t-out = 40, dc-t = 6, and ch-t = 18. PD dropout rate = 82, PD Tx rate = 18, PD death rate = 22. Conclusions: There is a high dropout rate for both PD and HD, rate is higher in PD. However, this increased rate of dropout in PD is mainly due to a markedly higher rate of Tx. Death rates were similar between the 2 modalities.






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