Evidence map›Paper›PMID 25170096›Full record

ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2014

The association between dialysis modality and the risk for dialysis technique and non-dialysis technique-related infections.

Anouk T N van Diepen, Tiny Hoekstra, Joris I Rotmans, Mark G J de Boer, Saskia le Cessie, Marit M Suttorp, Dirk G Struijk, Els W Boeschoten, Raymond T Krediet, Friedo W Dekker

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Peritoneal dialysis versus haemodialysis for people commencing dialysis.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Hospitalizations in Dialysis Patients in Canada: A National Cohort Study.Canadian journal of kidney health and disease · 2018
    Article
  6. Article
  7. Article
  8. Reducing the risk of infection in end-stage kidney failure patients treated by dialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2014
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Anouk T N van DiepenDivision of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Tiny HoekstraDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Joris I RotmansDepartment of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
Mark G J de BoerDepartment of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
Saskia le CessieDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
Marit M SuttorpDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Dirk G StruijkDivision of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Dianet, Amsterdam-Utrecht, The Netherlands.
Els W BoeschotenHans Mak Institute, Naarden, The Netherlands.
Raymond T KredietDivision of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Friedo W DekkerDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInfections are a major cause of morbidity and mortality among dialysis patients. Dialysis modality has been hypothesized to be a potential immunomodulatory factor. The objective of this study was to determine the influence of the first dialysis modality on the risk for infections on dialysis.

methodsOur study was conducted utilizing the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD) cohort of incident dialysis patients. Medical records of all patients from two tertiary care university hospitals and three regional hospitals were reviewed using pre-specified criteria. Information about infections was collected from the start of dialysis until death, modality switch, study withdrawal, kidney transplantation or at the end of the study. Age-standardized incidence rates for infections were calculated. Poisson regression analysis was used to calculate adjusted incidence rate ratios (IRRs).

resultsIn total, 452 patients, of whom 285 started with haemodialysis (HD) and 167 with peritoneal dialysis (PD), were included. The median follow-up time on the first dialysis modality was similar for HD and PD, 1.8 and 2.0 dialysis years, respectively. During the first 6 months, the age-standardized infection incidence rate was higher on HD compared with PD patients (P = 0.02). Overall, PD patients had a higher infection risk [adjusted IRR: 1.65, 95% confidence interval (CI): 1.34-2.03], which could be attributed to a 4-fold increased risk for dialysis technique-related infections. The risk for non-dialysis technique-related infections was lower in PD patients (adjusted IRR: 0.56, 95% CI: 0.40-0.79).

conclusionsOverall, PD patients carry a higher risk for infections. Interestingly, the risk for non-dialysis technique-related infections was higher in HD patients. The links between dialysis modality and the immune system are expected to explain this difference, but future studies are needed to test these assumptions.

Indexed as

Fluid TherapyKidney TransplantationRenal DialysisAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansInfectionsKidney Failure, ChronicMaleMiddle AgedMorbidityNetherlandsProspective Studiesepidemiologyhaemodialysisimmunologyinfectionperitoneal dialysis

Identifiers

PMID25170096

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.