{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:49:48Z","timestamp":1791560988353,"version":"4.3.4"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","funder":[{"name":"Vantive","id":[{"id":"https:\/\/ror.org\/01vc30847","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000000937","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T17:01:02Z","timestamp":1765386062000},"page":"1836-1846","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Sex-Specific Outcomes in the Peritoneal Dialysis Outcomes and Practice Patterns Study"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8760-5728","authenticated-orcid":false,"given":"Rehab","family":"Albakr","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhajanae","family":"Sylvertooth","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8505-0979","authenticated-orcid":false,"given":"Brian","family":"Bieber","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9695-0761","authenticated-orcid":false,"given":"Shilpanjali","family":"Jesudason","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-3460","authenticated-orcid":false,"given":"David W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia"},{"name":"Department of Kidney and Transplant Services, Princess Alexandra, Brisbane, Queensland, Australia"},{"name":"Translational Research Institute, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1207-0888","authenticated-orcid":false,"given":"Hideki","family":"Kawanishi","sequence":"additional","affiliation":[{"name":"Akane Foundation, Tsuchiya General Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosaku","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1344-3455","authenticated-orcid":false,"given":"Yong-Lim","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Medicine, Kyungpook National University, Daegu, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2996-8934","authenticated-orcid":false,"given":"Talerngsak","family":"Kanjanabuch","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine and Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2561-7413","authenticated-orcid":false,"given":"Mihran","family":"Naljayan","sequence":"additional","affiliation":[{"name":"Home Modalities, DaVita Kidney Care, Denver, Colorado"},{"name":"Division of Nephrology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0255-6710","authenticated-orcid":false,"given":"Roberto","family":"Pecoits-Filho","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald L.","family":"Pisoni","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-7623","authenticated-orcid":false,"given":"Jeffrey","family":"Perl","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4453-6486","authenticated-orcid":false,"given":"Edwina A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"issue":"12","key":"B1-20261009","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1038\/s41581-022-00623-7","article-title":"Epidemiology of peritoneal dialysis outcomes","volume":"18","author":"Bello","year":"2022","journal-title":"Nat Rev Nephrol."},{"issue":"3","key":"B2-20261009","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1177\/0896860819895356","article-title":"International comparison of peritoneal dialysis prescriptions from the Peritoneal Dialysis Outcomes and Practice Patterns Study 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