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Table 2 Results

From: A systematic review of the impact of center volume in dialysis

Author (pub year)

Study type

Region/country

Data source (period)

Dialysis

No. of patients

Volume definition

Hospital/centre volume [high/low]c

Afolalu 2009 [25]

Registry

US (New England)

SIMS (2001–2005; follow-up NR)

PD

5003

Based on case volume in 12/2005

>25 vs. ≤25

1 year mortalityb OR = 1.06 (p = 0.53)

2 years mortalityb OR = 1.09 (p = 0.41)

1year switch to HDµ OR=0.73 (p=0.005)

2 years switch to HDb OR = 0.74 (p = 0.03)

Castrale 2010 [26]

Registry

France

RDPLF (2000–2005; follow-up to 2007)

PD

1613

Number of all adult patients active on PD per day during study period

>30 vs.  <20

Switch to HD HR = 0.56a (0.37–0.86)

Survival free of peritonitis HR = 1.01a (0.77–1.33)

Survival (study period) HR = 0.96a (0.81–1.14)

Eisenstein 2008 [27]

Registry

US

USRDS (1996–1999; follow-up to 03/2001)

HD

1,86,596

NR

≥ 120 vs. ≤60

1 year survivalb OR = 1.24 (1.21–1.28)

2 years survivalb OR = 1.25 (1.22–1.29)

3 years survivalb OR = 1.29 (1.26–1.32)

4 years survivalb OR = 1.29 (1.26–1.32)

Evans 2013 [28]

Registry

France

RDPLF (2000–2009; follow-up to 2010)

PD

9602

12 month prior initiating treatment

>60 vs. ≤10

Switch to HD (5 years) HR = 0.46a (0.26–0.81)

Mortality (5 years) HR = 0.99a (0.72–1.36)

Transplantation (5 years) HR = 1.08a (0.73–1.61)

Fenton 1997 [30]

Registry

Canada

CORR (1990–1994; follow-up to 1994)

HD/PD

10,633

Patients between 1981 and 1994

≥400 vs. <400

Mortalityb RR = 0.85a (0.78–0.91)

Fenton 1993 [29]

Registry

Canada

CORR (1981–1991; follow-up to NR)

HD/PD

5476 (aged 65+)

NR

≥400 vs. <200

Mortality RR = 0.84a (p = 0.068)

Guo 2003 [24]

Registry

USA

BHC (1999–2001; follow up to 02/2003)

PD

32,135

NR

>20 vs. <20

Switch to HDb HRa = 0.88 (p ≤ 0.0001)

Huismann 2002 [22]

Registry

The Netherlands

RENINE (1994–1999; follow up to 01/2000)

PD

4049

NR

≥20 vs. <20

Switch to HD RRa = 0.60 (p < 0.0001)

Mortality RRa = NR (p > 0.05)

Lobbedez 2011 [31]

Registry

France

RDPLF (2002–2007; follow-up to 2008)

PD

4162

Mean number per day per centre over the study period

>30 vs. ≤20

Switch to HD HRa = 0.72 (0.56–0.92)

Peritonitis IRRa = 0.88 (0.74–1.05)

Enteric peritonitis IRRa = 1.02 (0.73–1.43)

Survival HRa = 0.98 (0.80–1.20)

Lobbedez 2012 [32]

Registry

France

RDPLF (2002–2010; follow-up to 06/2011)

PD

9801

new patients per year

>20 vs. <10

Switch to HD HRa = 0.83 (0.72–0.94)

Renal recovery HR = 1.61 (1.02–2.55)

Renal transplantation HR = 1.29 (1.13–1.48)

Mortality HR = 1.11 (1.00–1.21)

Martin 2011 [33]

Registry

Brazil

BRAZPD (12/2004–10/2007; follow-up > 90 days)

PD

2032

Quintiles (over study period)

>156 vs. <40

Peritonitis HRa = 0.67 (0.46–0.98)

Mircescu 2014 [37]

Registry

Romania

RRR (01/2008–12/2011; follow-up to 12/2012)

HD/PD

9252

Based on PD patients

≥20 vs. <20

Mortality HRa = 0.88 (0.81–0.97)

Mujais 2006 [34]

Registry

US

BHC (2000–2003; follow-up to 06/2005)

PD

40,869

NR

>39 vs. <10

Survival HR = NR (p > 0.05)

Switch to other treatment HRa = 0.94 (p < 0.0001) [risk decrease for each census category higher]

Transplantation HRa = 1.17 (p < 0.0001) [risk decrease for each census category higher]

Nolph 1986 [35]

Registry

US

CAPD Registry (late 1981–12/1985; follow-up to 08/1985)

PD

6431

Center size defined by number of follow-up patients

>70 vs. <6

Peritonitis Median rate 1.13 vs. 1.25 (p = NR)

Plantinga 2009 [36]

Clinical

US

ESRD Quality (EQUAL) Study (10/1995–06/1998; follow-up NR)

PD

236

Number of dialyzed patients in October 1998

>50 vs. ≤50

Switch to HD HRa = 0.25 (0.13–0.48)

Cardiovascular events HRa = 0.45 (0.29–0.70)

Cardiovascular mortality HRa = 0.63 (0.30–1.34)

Mortality HRa = 0.78 (0.48–1.26)

Schaubel 2001 [23]

Registry

Canada

CORR (1981–1997; follow-up to 1997)

PD

17,900

Cumulative number of patients treated

≥500 vs. ≤99

Mortality RRa = 0.71 (0.63–0.81)

Switch to HD RRa = 0.83 (0.73–0.95)

  1. HD hemodialysis, PD peritoneal dialysis, IRR incidence rate ratio, RR risk ration, OR odds ratio, HR hazard ratio, SIMS Standard Information Management System, RDPLF French Peritoneal Dialysis Registry, USRDS United States renal data system, CORR Canadian Organ Replacement Register, BHC Baxter Healthcare Corporation, BRAZPD Brazilian Peritoneal Dialysis Study, RRR Romanian Renal Registry, CAPD continuous ambulatory peritoneal dialysis, RENINE Dutch End-Stage Renal Disease Registry, NR not reported
  2. aAdjusted analysis
  3. bRe-analysed from data reported in the publication (not reported by the authors)
  4. cCut-off values presented for highest vs. lowest group