SynthesisPloS one2022
Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States.PloS one · 2022Pooled it
- Comparison of the effect of aerobic and resistance training on fatigue, quality of life and biochemical factors in hemodialysis patients.Scientific reports · 2025Trial
- The Feasibility of Home-Based Moxibustion for Fatigue in Peritoneal Dialysis: A Randomized Controlled Pilot Trial.Healthcare (Basel, Switzerland) · 2026Article
- Sleep-Related Disorders in Patients with CKD and Kidney Transplant Recipients.Clinical journal of the American Society of Nephrology : CJASN · 2025Review
- Exploring symptom clusters in Chinese patients with peritoneal dialysis: a network analysis.Renal failure · 2024Article
- Prevalence and influencing factors of fatigue among patients undergoing continuous ambulatory peritoneal dialysis: A cross-sectional study.Belitung nursing journal · 2023Article
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders.
methodsWe conducted a side-by-side study from two of incident PD patients in Brazil and the United States. We used the same code to independently analyze data in both countries during 2004 to 2011. We included data from adults who completed KDQOL-SF vitality subscale within 90 days after starting PD. Vitality score was categorized in four groups: >50 (high vitality), ≥40 to ≤50 (moderate vitality), >35 to <40 (moderate fatigue), ≤35 (high fatigue; reference group). In each country's cohort, we built four distinct models to estimate the associations between vitality (exposure) and all-cause mortality (outcome): (i) Cox regression model; (ii) competing risk model accounting for technique failure events; (iii) multilevel survival model of clinic-level clusters; (iv) multivariate regression model with smoothing splines treating vitality as a continuous measure. Analyses were adjusted for age, comorbidities, PD modality, hemoglobin, and albumin. A mixed-effects meta-analysis was used to pool hazard ratios (HRs) from both cohorts to model mortality risk for each 10-unit increase in vitality.
resultsWe used data from 4,285 PD patients (Brazil n = 1,388 and United States n = 2,897). Model estimates showed lower vitality levels within 90 days of starting PD were associated with a higher risk of mortality, which was consistent in Brazil and the United States cohorts. In the multivariate survival model, each 10-unit increase in vitality score was associated with lower risk of all-cause mortality in both cohorts (Brazil HR = 0.79 [95%CI 0.70 to 0.90] and United States HR = 0.90 [95%CI 0.88 to 0.93], pooled HR = 0.86 [95%CI 0.75 to 0.98]). Results for all models provided consistent effect estimates.
conclusionsAmong patients in Brazil and the United States, lower vitality score in the initial months of PD was independently associated with all-cause mortality.
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