Sex-Specific Outcomes in the Peritoneal Dialysis Outcomes and Practice Patterns Study
Bibliographic record
Abstract
Sex differences may influence peritoneal dialysis (PD) outcomes for individuals with kidney failure and remain poorly understood. Understanding these differences is important in optimizing dialysis care and addressing disparities in treatment outcomes. We sought to explore association of sex with PD outcomes. Data from the international PD Outcomes and Practice Patterns Study across eight countries were used to examine sex differences in outcomes, including mortality, transfer to hemodialysis, the composite of both, peritonitis risks, and kidney transplantation. Cause-specific Cox regression models were used to assess the association between sex and each clinical outcome, adjusting for region, comorbidities, demographic, and treatment characteristics. Of 26,292 included individuals on PD, 43% were female, ranging from 34% in Japan to 51% in Thailand. Women (compared with men) had lower mortality (rate per 100 patient-years [PY100], 10.9 versus 11.3; adjusted hazard ratio [aHR] of mortality, 0.92 [95% confidence intervals (CIs), 0.86 to 0.99]), transfer to hemodialysis (PY100, 16.3 versus 17.9; aHR, 0.87 [95% CI, 0.83 to 0.92]), the composite of both (PY100, 27.2 versus 29.0; aHR, 0.89 [95% CI, 0.85 to 0.93]), and time to first observed peritonitis (PY100, 17.5 versus 18.7; aHR, 0.90 [95% CI, 0.84 to 0.95]), while transplant hazards were similar (PY100, 4.0 versus 4.0; aHR, 0.97 [95% CI, 0.87 to 1.08]). In subgroup and additional analyses, sex differences in outcomes were particularly apparent in South Korea, with a median time on PD of 6.4 years for women and 4.9 years for men, with South Korea women having lower hemodialysis transfer and transplant rates. Across all countries, diabetes substantially attenuated the lower risks of death and hemodialysis transfer in women. Women had significantly lower risks of gram-positive peritonitis (aHR, 0.73 [95% CI, 0.65 to 0.82]). Compared with men, women receiving PD have lower likelihoods of mortality, hemodialysis transfer, and peritonitis. Better understanding of these findings will help inform sex-specific strategies for managing PD while enhancing personalized care approaches in this patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".