The proportion of home dialysis patients has declined in recent years. Furthermore, the usage of home dialysis varies greatly amongst centers. Therefore, it was unclear if it was due to comorbidity differences or other causes. Therefore, for a study, researchers sought to determine the relationship between comorbidity and dialysis method selection.
From 2012 to 2016, the multi-center DOMESTICO cohort research collected comorbidity data on patients who began dialysis in 35 Dutch centers. The Charlson comorbidity index was used to measure comorbidity. Home dialysis was defined as peritoneal dialysis or home hemodialysis therapy during follow-up. A multivariable logistic regression analysis was conducted to examine the relationship between comorbidity and dialysis modality, with a mixed model approach employed to account for patient clustering within dialysis centers.
A total of 1,358 patients were involved in the study, with 628 receiving home dialysis. In crude mixed model analysis, having a high comorbidity score resulted in an odds ratio of 0.74 (95% CI 0.54-1.00) when compared to patients who did not have comorbidities. There was no connection between comorbidity and home dialysis after adjusting for age, gender, ethnic origin, body mass index, and dialysis vintage.
After controlling for many confounding variables such as age and body mass index, comorbidity was not substantially linked with home dialysis preference. Therefore, future research should focus on elucidating the center-specific features that most likely influence dialysis modality selection.
Reference: onlinelibrary.wiley.com/doi/10.1111/nep.14033
