Landmark study provides key to improved survival in peritoneal dialysis patients

Clinicians and scientists from Keele and Cardiff universities have published data from a landmark study that explains why survival in patients on peritoneal dialysis is low.

Peritoneal dialysis (PD) is a treatment for over 250,000 patients with worldwide, using the patient's peritoneum in the . Currently, only one in ten PD patients survives beyond 10 years on dialysis. For each one-year increase in the patient's age, the risk of death increases by 4% and patients with diabetes have a 30% increased risk of death.

Scientists have now discovered that in the body and in the (where dialysis is performed) are a separate process, which has implications for both the ability to perform dialysis and patient survival. In effect, systemic (whole body) inflammation controls the outcome (survival) whilst peritoneal inflammation controls membrane survival.

Professor Nicholas Topley from Cardiff University and Professor Simon Davies from Keele University designed the study that has taken 12 years to complete:

"Improving survival and doing better dialysis to improve quality of life is the key goal of our research," said Professor Topley from Cardiff University's School of Medicine. "This study was a hard one to bring home because of its length of follow up and the logistics of collecting patient samples worldwide. The importance of the results is self-evident - this is a big leap forward for PD."

Professor Simon Davies, lead investigator from Keele University, said: "We will now be able to target inflammation to improve survival and recovery. Of course there is more to be done but this will form the basis of understanding that to holistically treat the patient one needs to define the clinical problem."

The 12-year international study, with 10 centres in the UK, Korea and Canada, is the longest and largest of its kind. Researchers recruited more than 1500 patients to the study over a 10-year period and then performed a detailed clinical and immunological analysis of samples obtained from PD patients. This for the first time characterised inflammation in these patients and linked it directly to patient outcomes.

The data will enable who treat PD patients to be able to target treatment where it is needed, thereby improving and extending the therapy, quality of life and reducing treatment failure.

Dialysis treatment is a daily reality for patients with kidney failure which can last for many years and incurs a huge annual cost for the NHS. A UK estimate suggests that renal disease costs the NHS in England £1.45 billion and £800million in Wales, annually.

More than 250,000 worldwide use as their primary form of renal replacement therapy.

More information: 'Independent Effects of Systemic and Peritoneal Inflammation on Peritoneal Dialysis Survivalis published today in the Journal of the American Society of Nephrology.

add to favorites email to friend print save as pdf

Related Stories

Peritoneal dialysis as an intervention for stroke patients

Sep 03, 2013

Ischemic stroke is characterized by an interruption of the blood supply to the brain, which can lead to brain damage and even death. Excess amounts of the excitatory neurotransmitter glutamate are released during stroke events ...

Snapshot of dialysis: Who's getting treated at home?

Feb 02, 2012

Home-based dialysis treatments are on the rise in both the developing and developed worlds, but developed countries appear to be turning to them less often, according to a study appearing in an upcoming issue of the Journal of ...

Recommended for you

Two US states order tough Ebola quarantine rules

15 hours ago

New York and New Jersey on Friday ordered a mandatory quarantine for medics who treated victims of Ebola in West Africa, after the deadly virus spread to America's largest city.

NY and NJ say they will require Ebola quarantines

Oct 24, 2014

The governors of New Jersey and New York on Friday ordered a mandatory, 21-day quarantine for all doctors and other arriving travelers who have had contact with Ebola victims in West Africa.

User comments