Landmark study provides key to improved survival in peritoneal dialysis patients

September 23, 2013

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.

Explore further: Peritoneal dialysis as an intervention for stroke patients

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

Related Stories

Peritoneal dialysis as an intervention for stroke patients

September 3, 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 ...

Quality of life and treatment of late-stage chronic kidney disease

September 11, 2012
Renal transplantation is best treatment option for improving quality of life in people with late-stage chronic kidney disease

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

February 2, 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 ...

Surprising results for use of dialysis for kidney failure in developing world

April 26, 2012
Researchers at Lawson Health Research Institute have discovered that developing countries have faster growing rates of use of home-based dialysis (called peritoneal dialysis) for kidney failure than the developed world. Despite ...

Recommended for you

New test differentiates between Lyme disease, similar illness

August 16, 2017
Lyme disease is the most commonly reported vector-borne illness in the United States. But it can be confused with similar conditions, including Southern Tick-Associated Rash Illness. A team of researchers led by Colorado ...

Addressing superbug resistance with phage therapy

August 16, 2017
International research involving a Monash biologist shows that bacteriophage therapy – a process whereby bacterial viruses attack and destroy specific strains of bacteria - can be used successfully to treat systemic, multidrug ...

Can previous exposure to west Nile alter the course of Zika?

August 15, 2017
West Nile virus is no stranger to the U.S.-Mexico border; thousands of people in the region have contracted the mosquito-borne virus in the past. But could this previous exposure affect how intensely Zika sickens someone ...

Compounds in desert creosote bush could treat giardia and 'brain-eating' amoeba infections

August 15, 2017
Researchers at Skaggs School of Pharmacy and Pharmaceutical Sciences at University of California San Diego and the University of Colorado Anschutz Medical Campus have found that compounds produced by the creosote bush, a ...

New malaria analysis method reveals disease severity in minutes

August 11, 2017
Left untreated, malaria can progress from being mild to severe—and potentially fatal—in 24 hours. So researchers at the University of British Columbia developed a method to quickly and sensitively assess the progression ...

Drug trial shows promise for deadly neurological disorder

August 10, 2017
Results of a small clinical trial show promise for treating a rare neurodegenerative condition that typically kills those afflicted before they reach age 20. The disease, called Niemann-Pick type C (NPC), causes cholesterol ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.