Systematic differences among patients initiated on home haemodialysis and peritoneal dialysis: the fallacy of potential competition
Bibliographic record
Abstract
BACKGROUND: The adoption of home-based dialysis therapies is growing internationally. There is a possibility that competition for patients may exist between peritoneal dialysis (PD) and home haemodialysis (HHD) for their respective growth. METHODS: Clinical demographics of patients initiating PD and HHD from 2004 to 2008 in our centre were abstracted using institutional electronic records. We compared clinical demographics, laboratory data and process of care to describe potential factors leading to patients choosing home-based dialysis therapies. RESULTS: Between 2004 and 2008, 236 patients initiated home dialysis therapy in our centre: 153 patients to PD and 83 patients to HHD. PD and HHD patients differed in age (PD 62 +/- 16 vs HHD 46 +/- 13 years; P < 0.001) and gender distribution (PD 57 vs HHD 70% male; P = 0.05). A higher proportion of PD patients had diabetes and hypertension as the primary cause of their end-stage renal disease (ESRD). In contrast, there were more patients with glomerulonephritis among the HHD cohort. Cardiovascular and peripheral vascular diseases were more common among patients on PD. HHD patients had longer ESRD vintage (PD 0.34 +/- 0.69 and HHD 4.8 +/- 6.8 years on therapy; P = 0.002). The proportion of patients receiving chronic kidney disease care was higher among PD starters (PD 86 vs HHD 65%; P < 0.001). Sixteen percent of PD patients and 9% of HHD patients initiated their home-based renal replacement therapy after an acute hospitalization without prior modality education. CONCLUSION: There is a systematic difference between patients initiated on PD and HHD. Our data reaffirm that modality selection is a complex process. Patients on the two home therapies differ demographically and arrive through different routes. This finding suggests that the two home-based modalities are not in competition.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".