{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:38:52Z","timestamp":1789004332150,"version":"build-2803163510"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\nIntroduction<\/jats:title>\nThe integrated care model considers sequences of kidney replacement therapies rather than individual modalities. Data from conventional registries describing trajectories are partial. The aim was to provide a complete description of the peritoneal dialysis pathway.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nPatients undergoing peritoneal dialysis in France between January 1, 2009, and December 31, 2019, were included. Data from the national REIN (Renal Epidemiology and Information Network) registry and the SNDS (Administrative Database of Outpatient and Inpatient Care Consumption) database were used. Patient trajectories and status (peritoneal dialysis, hemodialysis, mixed and hybrid dialysis, kidney transplantation, and death) were reconstructed. Each dialysis session, even a single day, was recorded. The trajectory was described using a Sankey diagram.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nA total of 5,053 patients in the REIN registry and the SNDS database underwent peritoneal dialysis at some point. The Sankey diagram showed the great diversity and complexity of care pathways. Only 1,652 (33%) of patients underwent peritoneal dialysis only. A total of 1,807 (36%) patients changed kidney replacement therapy 2 times or more. There was high permeability between peritoneal dialysis and hemodialysis: 1,358 (27%) patients transferred from hemodialysis to peritoneal dialysis and 2,018 (40%) transferred from peritoneal dialysis to hemodialysis. A total of 251 (5%) patients underwent hybrid dialysis. A total of 498 (10%) patients experienced an unstable period of mixed dialysis and managed to return to peritoneal dialysis for a significant time (median of 339 days). The causes of transfers were not available.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nOur results describe a more precise view of the trajectories of peritoneal dialysis patients compared to data from conventional registries. Peritoneal dialysis is a component of a multimodal pathway, as two thirds are likely to receive another kidney replacement therapies. Ongoing information about other kidney replacement therapies regimens seems necessary for peritoneal dialysis patients. The organization of each dialysis center must integrate and facilitate these transfers.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0326745","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T17:33:17Z","timestamp":1754415197000},"page":"e0326745","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["The diversity of peritoneal dialysis care trajectories: A study based on the REIN registry and SNDS database"],"prefix":"10.1371","volume":"20","author":[{"given":"Bruno","family":"Legendre","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Lobbedez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Couchoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0178-7389","authenticated-orcid":true,"given":"Antoine","family":"Lanot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Kolko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Courivaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabel","family":"Boyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8481-6589","authenticated-orcid":true,"given":"Cl\u00e9mence","family":"B\u00e9chade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"issue":"1","key":"pone.0326745.ref001","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1681\/ASN.V111116","article-title":"An evaluation of an integrative care approach for end-stage renal disease patients","volume":"11","author":"WV Biesen","year":"2000","journal-title":"J Am Soc Nephrol"},{"key":"pone.0326745.ref002","doi-asserted-by":"crossref","DOI":"10.1177\/089686080102103S47","article-title":"Integrated care","volume":"21","author":"SJ Davies","year":"2001","journal-title":"Perit Dial Int"},{"key":"pone.0326745.ref003","article-title":"Mortality studies comparing peritoneal dialysis and hemodialysis: what do they tell us?","volume":"103","author":"EF Vonesh","year":"2006","journal-title":"Kidney Int Suppl"},{"issue":"1","key":"pone.0326745.ref004","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/089686080202200101","article-title":"Reformulating the integrated care concept for the new millennium","volume":"22","author":"DC Mendelssohn","year":"2002","journal-title":"Perit Dial Int"},{"issue":"1","key":"pone.0326745.ref005","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3747\/pdi.2017.00242","article-title":"Transition between different renal replacement modalities: gaps in knowledge and care - the integrated research initiative","volume":"39","author":"C Chan","year":"2019","journal-title":"Perit Dial Int"},{"issue":"6","key":"pone.0326745.ref006","first-page":"415","article-title":"Description of trajectories of patients with end-stage renal disease from the REIN registry","volume":"17","author":"M Buzzi","year":"2021","journal-title":"Nephrol Ther"},{"issue":"7","key":"pone.0326745.ref007","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0254931","article-title":"Renal staffs\u2019 understanding of patients\u2019 experiences of transition from peritoneal dialysis to in-centre haemodialysis and their views on service improvement: A multi-site qualitative study in England and Australia","volume":"16","author":"JE Jones","year":"2021","journal-title":"PLoS One"},{"issue":"4","key":"pone.0326745.ref008","doi-asserted-by":"crossref","first-page":"391","DOI":"10.3747\/pdi.2011.00134","article-title":"Is transition between peritoneal dialysis and hemodialysis really a gradual process?","volume":"33","author":"L Boissinot","year":"2013","journal-title":"Perit Dial Int"},{"issue":"5","key":"pone.0326745.ref009","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/j.ekir.2022.02.016","article-title":"Mortality Trends After Transfer From Peritoneal Dialysis to Hemodialysis","volume":"7","author":"A-C Nadeau-Fredette","year":"2022","journal-title":"Kidney Int Rep"},{"issue":"10","key":"pone.0326745.ref010","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.39131","article-title":"Assessment of Spending for Patients Initiating Dialysis Care","volume":"5","author":"RJ League","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"3","key":"pone.0326745.ref011","doi-asserted-by":"crossref","first-page":"297","DOI":"10.3747\/pdi.2014.00288","article-title":"The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis","volume":"36","author":"J Perl","year":"2016","journal-title":"Perit Dial Int"},{"issue":"6","key":"pone.0326745.ref012","doi-asserted-by":"crossref","first-page":"623","DOI":"10.3747\/pdi.2015.00218","article-title":"Duration of Hemodialysis Following Peritoneal Dialysis Cessation in Australia and New Zealand: Proposal for a Standardized Definition of Technique Failure","volume":"36","author":"PG Lan","year":"2016","journal-title":"Perit Dial Int"},{"issue":"3","key":"pone.0326745.ref013","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1053\/j.ajkd.2019.09.017","article-title":"Establishing a Core Outcome Set for Peritoneal Dialysis: Report of the SONG-PD (Standardized Outcomes in Nephrology-Peritoneal Dialysis) Consensus Workshop","volume":"75","author":"KE Manera","year":"2020","journal-title":"Am J Kidney Dis"},{"issue":"10","key":"pone.0326745.ref014","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1038\/s41581-021-00439-x","article-title":"Big Data in Nephrology","volume":"17","author":"N Kaur","year":"2021","journal-title":"Nat Rev Nephrol"},{"issue":"2","key":"pone.0326745.ref015","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1093\/ndt\/gfi198","article-title":"The renal epidemiology and information network (REIN): a new registry for end-stage renal disease in France","volume":"21","author":"C Couchoud","year":"2006","journal-title":"Nephrol Dial Transplant"},{"issue":"1","key":"pone.0326745.ref016","doi-asserted-by":"crossref","DOI":"10.1093\/ckj\/sfad240","article-title":"Twenty years of the French Renal Epidemiology and Information Network","volume":"17","author":"I Kazes","year":"2023","journal-title":"Clin Kidney J"},{"key":"pone.0326745.ref017","article-title":"Value of a national administrative database to guide public decisions: From the syst\u00e8me national d\u2019information interr\u00e9gimes de l\u2019Assurance Maladie (SNIIRAM) to the syst\u00e8me national des donn\u00e9es de sant\u00e9 (SNDS) in France","author":"P Tuppin","year":"2017","journal-title":"Rev Epidemiol Sante Publique"},{"issue":"1","key":"pone.0326745.ref018","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12882-020-1692-4","article-title":"Linking disease registries and nationwide healthcare administrative databases: the French renal epidemiology and information network (REIN) insight","volume":"21","author":"M Raffray","year":"2020","journal-title":"BMC Nephrol"},{"issue":"2","key":"pone.0326745.ref019","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1177\/089686080602600205","article-title":"Combination therapy with peritoneal dialysis and hemodialysis","volume":"26","author":"H Kawanishi","year":"2006","journal-title":"Perit Dial Int"},{"key":"pone.0326745.ref020","article-title":"Mortality, hospitalization and transfer to haemodialysis and hybrid therapy, in Japanese peritoneal dialysis patients","author":"H Kawanishi","year":"2021","journal-title":"Perit Dial Int"},{"issue":"1","key":"pone.0326745.ref021","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1526-0968.2004.00107.x","article-title":"Review of combination of peritoneal dialysis and hemodialysis as a modality of treatment for end-stage renal disease","volume":"8","author":"H Fukui","year":"2004","journal-title":"Ther Apher Dial"},{"key":"pone.0326745.ref022","first-page":"218","article-title":"Exploring Patient Path Through Sankey Diagram: A Proof of Concept","volume":"270","author":"A Lamer","year":"2020","journal-title":"Stud Health Technol Inform"},{"key":"pone.0326745.ref023","author":"R Core Team","year":"2020"},{"key":"pone.0326745.ref024","author":"REIN","year":"2023"},{"issue":"3","key":"pone.0326745.ref025","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1177\/0896860820975596","article-title":"How do patients and their family members experience the transition from peritoneal dialysis to incentre haemodialysis? A multisite qualitative study in England and Australia","volume":"42","author":"K Allen","year":"2022","journal-title":"Perit Dial Int"},{"issue":"3","key":"pone.0326745.ref026","doi-asserted-by":"crossref","first-page":"297","DOI":"10.3747\/pdi.2013.00147","article-title":"The impact of transfer from hemodialysis on peritoneal dialysis technique survival","volume":"35","author":"SJ Nessim","year":"2015","journal-title":"Perit Dial Int"},{"issue":"12","key":"pone.0326745.ref027","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.2215\/CJN.05910519","article-title":"Trends in Peritoneal Dialysis Use in the United States after Medicare Payment Reform","volume":"14","author":"CE Sloan","year":"2019","journal-title":"Clin J Am Soc Nephrol"},{"issue":"11","key":"pone.0326745.ref028","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1093\/ndt\/gft055","article-title":"Early failure in patients starting peritoneal dialysis: a competing risks approach","volume":"29","author":"C B\u00e9chade","year":"2014","journal-title":"Nephrol Dial Transplant"},{"key":"pone.0326745.ref029","first-page":"1","article-title":"Switch from hemodialysis to peritoneal dialysis: does the time spent on hemodialysis impact outcomes in peritoneal dialysis?","author":"B Legendre","year":"2022","journal-title":"Am J Nephrol"},{"issue":"6","key":"pone.0326745.ref030","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1177\/089686080002000633","article-title":"The effect of hemodialysis during break-in period on residual renal function in CAPD patients","volume":"20","author":"DJ Kim","year":"2000","journal-title":"Perit Dial Int"},{"issue":"2","key":"pone.0326745.ref031","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1053\/j.ajkd.2018.01.035","article-title":"Improving Incident ESRD Care Via a Transitional Care Unit","volume":"72","author":"B Bowman","year":"2018","journal-title":"Am J Kidney Dis"},{"issue":"11","key":"pone.0326745.ref032","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.34067\/KID.0004052020","article-title":"Characteristics and Effectiveness of Dedicated Care Programs for Patients Starting Dialysis: A Systematic Review","volume":"1","author":"M Attalla","year":"2020","journal-title":"Kidney360"},{"issue":"2","key":"pone.0326745.ref033","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1053\/j.ajkd.2011.04.015","article-title":"Effects of a nationwide predialysis educational program on modality choice, vascular access, and patient outcomes","volume":"58","author":"Jr Lacson E","year":"2011","journal-title":"Am J Kidney Dis"},{"issue":"3","key":"pone.0326745.ref034","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1053\/j.ajkd.2012.04.009","article-title":"The IMPACT (Incident Management of Patients, Actions Centered on Treatment) program: a quality improvement approach for caring for patients initiating long-term hemodialysis","volume":"60","author":"SM Wilson","year":"2012","journal-title":"Am J Kidney Dis"},{"issue":"12","key":"pone.0326745.ref035","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.2215\/CJN.03430317","article-title":"Multi-Disciplinary Vascular Access Care and Access Outcomes in People Starting Hemodialysis Therapy","volume":"12","author":"S Gill","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"issue":"3","key":"pone.0326745.ref036","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1684\/ndt.2023.17","article-title":"From transfer to transition: review and proposition of the SFNDT dialysis Commission","volume":"19","author":"A Boyer","year":"2023","journal-title":"Nephrol Ther"},{"issue":"3","key":"pone.0326745.ref037","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3747\/pdi.2013.00030","article-title":"Predictors and outcomes of transfers from peritoneal dialysis to hemodialysis","volume":"35","author":"PG Lan","year":"2015","journal-title":"Perit Dial Int"},{"issue":"10","key":"pone.0326745.ref038","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1093\/ndt\/gfu050","article-title":"Peritoneal dialysis outcomes after temporary haemodialysis transfer for peritonitis","volume":"29","author":"Y Cho","year":"2014","journal-title":"Nephrol Dial Transplant"},{"issue":"2","key":"pone.0326745.ref039","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1093\/ndt\/gfaa289","article-title":"Assisted peritoneal dialysis and transfer to haemodialysis: a cause-specific analysis with data from the RDPLF","volume":"36","author":"A Lanot","year":"2021","journal-title":"Nephrol Dial Transplant"},{"issue":"6","key":"pone.0326745.ref040","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1177\/0896860819896219","article-title":"Patients\u2019 experiences of transitioning between different renal replacement therapy modalities: A qualitative study","volume":"40","author":"E Holvoet","year":"2020","journal-title":"Perit Dial Int"},{"issue":"10","key":"pone.0326745.ref041","doi-asserted-by":"crossref","first-page":"2835","DOI":"10.1681\/ASN.2017020212","article-title":"The Trauma of Dialysis Initiation","volume":"28","author":"G Hercz","year":"2017","journal-title":"J Am Soc Nephrol"},{"issue":"10","key":"pone.0326745.ref042","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1093\/ndt\/gfad019","article-title":"Comparable outcomes between a combination of peritoneal dialysis with once-weekly haemodialysis and thrice-weekly haemodialysis: a prospective cohort study","volume":"38","author":"M Murashima","year":"2023","journal-title":"Nephrol Dial Transplant"},{"issue":"3","key":"pone.0326745.ref043","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1177\/08968608241246447","article-title":"Assisted peritoneal dialysis: Position paper for the ISPD","volume":"44","author":"MJ Oliver","year":"2024","journal-title":"Perit Dial Int"},{"key":"pone.0326745.ref044","author":"REIN","year":"2024"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0326745","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T17:33:25Z","timestamp":1754415205000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0326745"}},"subtitle":[],"editor":[{"given":"Wisit","family":"Kaewput","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":44,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0326745","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]}}}