ArticleBMC nephrology2012
Overestimation of the probability of death on peritoneal dialysis by the Kaplan-Meier method: advantages of a competing risks approach.
Article in BMC nephrology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Survival prognosis after the start of a renal replacement therapy in the Netherlands: a retrospective cohort study.BMC nephrology · 2013Trial
- Transplantation Improves Patient Survival in a PD-first Program in South Africa.Transplantation direct · 2026Article
- New horizons in the analysis of hospital readmissions of older adults.Aging clinical and experimental research · 2023Article
- Risk factors associated with outcomes of peritoneal dialysis in Taiwan: An analysis using a competing risk model.Medicine · 2019Observational
- Technique failure in Korean incident peritoneal dialysis patients: a national population-based study.Kidney research and clinical practice · 2016Article
- Clinical-pathological characteristics and prognosis of a cohort of oesophageal cancer patients: a competing risks survival analysis.Journal of epidemiology · 2015Article
- Registration on the renal transplantation waiting list and mortality on dialysis: an analysis of the French REIN registry using a multi-state model.Journal of epidemiology · 2015Article
- Risk factors of CVD mortality among the elderly in Beijing, 1992 - 2009: an 18-year cohort study.International journal of environmental research and public health · 2014Article
- Risk factors for cerebrovascular disease mortality among the elderly in Beijing: a competing risk analysis.PloS one · 2014Article
- Article
- Modelling competing risks in nephrology research: an example in peritoneal dialysis.BMC nephrology · 2013Article
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7 authors.
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Abstract
backgroundIn survival analysis, patients on peritoneal dialysis are confronted with three different outcomes: transfer to hemodialysis, renal transplantation, or death. The Kaplan-Meier method takes into account one event only, so whether it adequately considers these different risks is questionable. The more recent competing risks method has been shown to be more appropriate in analyzing such situations.
methodsWe compared the estimations obtained by the Kaplan-Meier method and the competing risks method (namely the Kalbfleisch and Prentice approach), in 383 consecutive incident peritoneal dialysis patients. By means of simulations, we then compared the Kaplan-Meier estimations obtained in two virtual centers where patients had exactly the same probability of death. The only difference between these two virtual centers was whether renal transplantation was available or not.
resultsAt five years, 107 (27.9%) patients had died, 109 (28.4%) had been transferred to hemodialysis, 91 (23.8%) had been transplanted, and 37 (9.7%) were still alive on peritoneal dialysis; before five years, 39 (10.2%) patients were censored alive on peritoneal dialysis. The five-year probabilities estimated by the Kaplan-Meier and the competing risks methods were respectively: death: 50% versus 30%; transfer to hemodialysis: 59% versus 32%; renal transplantation: 39% versus 26%; event-free survival: 12% versus 12%. The sum of the Kaplan-Meier estimations exceeded 100%, implying that patients could experience more than one event, death and transplantation for example, which is impossible. In the simulations, the probability of death estimated by the Kaplan-Meier method increased as the probability of renal transplantation increased, although the probability of death actually remained constant.
conclusionThe competing risks method appears more appropriate than the Kaplan-Meier method for estimating the probability of events in peritoneal dialysis in the context of univariable survival analysis.
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