Evaluation of the Integrated Home Dialysis Model

Study Overview
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Brief Summary
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The purpose of this study is to evaluate which home dialysis modality pattern (home hemodialysis [HHD], peritoneal dialysis [PD] or a combination of both, e.g. PD and then HHD) allows for the longest home dialysis survival, as defined by the time dialysed in a home environment. The investigators hypothesize that patients transferred from one home modality to another will have a longer home dialysis survival compared to patients treated only with PD or HHD.

Conditions
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Kidney Failure, Chronic

Intervention / Treatment
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* Procedure: Peritoneal dialysis
* Procedure: Home hemodialysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with PD/HHD 90 days after RRT initiation between January 1, 2000 and December 31, 2012 reported in ANZDATA ≥ 18 years Exclusion Criteria: Less than 90 days of dialysis < 18 years Patients transferred to Australia/New Zealand after initiation of dialysis in another country

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Peritoneal dialysis only<br>Patient on PD modality 90 days after renal replacement therapy initiation and not transferred to HHD | Procedure: Peritoneal dialysis<br> <br> |
| Home hemodialysis only<br>Patient on HHD 90 days after renal replacement therapy initiation and not transferred to PD | Procedure: Home hemodialysis<br> <br> |
| PD and HHD<br>Patient on PD 90 days after RRT initiation and transferred to HHD less than 90 days after PD failure | Procedure: Peritoneal dialysis<br> <br> Procedure: Home hemodialysis<br> <br> |
| HHD and PD<br>Patient on HHD after RRT initiation and transferred to PD less than 90 days after HHD failure | Procedure: Peritoneal dialysis<br> <br> Procedure: Home hemodialysis<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Home dialysis survival | Time to first patient death or home dialysis technique failure for each home dialysis modalities, censored for transplantation and loss to follow-up | Survival analysis; specific analysis at 5 years after dialysis initiation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient survival, censored for technique failure | Patient survival on each specific home dialysis modality, censored for technique failure, transplantation and loss to follow-up | Survival analysis, specific analysis at 1,2 5 years after dialysis initiation | 
| Home technique survival, censored for death | Home dialysis technique survival for each home dialysis modality, censored for patient death, transplantation and loss to follow-up | survival analysis, specific analysis at 1,2 5 years after dialysis initiation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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end-stage kidney disease, peritoneal dialysis, home hemodialysis, technique survival, patient survival