Sex disparities in in-hospital treatments, outcomes, and resource utilization among peritoneal dialysis patients: A nationwide inpatient sample analysis
Issued Date
2025-01-01
Resource Type
ISSN
08968608
eISSN
17184304
Scopus ID
2-s2.0-105012536092
Journal Title
Peritoneal Dialysis International
Rights Holder(s)
SCOPUS
Bibliographic Citation
Peritoneal Dialysis International (2025)
Suggested Citation
Thongprayoon C., Kaewput W., Wathanavasin W., Suppadungsuk S., Davis P.W., Tangpanithandee S., Cheungpasitporn W. Sex disparities in in-hospital treatments, outcomes, and resource utilization among peritoneal dialysis patients: A nationwide inpatient sample analysis. Peritoneal Dialysis International (2025). doi:10.1177/08968608251362904 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/111621
Title
Sex disparities in in-hospital treatments, outcomes, and resource utilization among peritoneal dialysis patients: A nationwide inpatient sample analysis
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Sex-based differences may influence the clinical management, complication risks, and healthcare resource utilization of hospitalized end-stage kidney disease (ESKD) patients undergoing peritoneal dialysis (PD). Understanding these disparities is essential for optimizing patient care and informing healthcare policy. Methods: This study was conducted using the National Inpatient Sample to identify hospitalized adult ESKD patients receiving PD from the year 2003 to 2018. The outcomes included 1) PD-related outcomes, defined as a composite of peritonitis, mechanical complications, catheter removal or revision, and adequacy issues, 2) non-PD-related outcomes, defined as a composite of sepsis, cardiac arrest, and need for mechanical ventilation 3) transfer to hemodialysis, and 4) in-hospital mortality. The associations between sex and in-hospital outcomes were analyzed using multivariable logistic regression and were adjusted for demographic factors, comorbidities, primary diagnoses, admission types, and hospital characteristics. Discharge weights were applied to generate nationally representative estimates. Results: Of 97,036 hospitalized ESKD patients receiving PD analyzed, 48,906 (50.4%) were females. In adjusted analyses, there were no overall sex differences in PD-related outcomes, non-PD-related outcomes, or in-hospital mortality. However, age- and comorbidity-based variations were observed in PD-related outcomes. Female sex was associated with lower odds of transfer to hemodialysis, particularly among younger patients and those without heart failure or peripheral vascular disease. Notably, sex differences in in-hospital mortality were observed only among patients with elective admissions. Conclusion: There were sex-based disparities in the outcomes and healthcare utilization of hospitalized ESKD patients receiving PD. These findings underscore the need for sex-specific, individualized strategies to improve PD care and inform clinical and policy decisions.