Treatment Outcomes and Prognostic Factors for Peritoneal Dialysis Patients Based on Single Center Experience over 18 years

Yoon, Hyun Bae; Park, Hayne Cho; Lee, Hajeong; Han, Seung Suk; Kim, Sejoong; Joo, Kwon Wook; Kim, Yon Su; Ahn, Curie; Han, Jin Suk; Kim, Suhnggwon; Oh, Kook Hwan

Abstract

PURPOSE:We investigated the survival rate, factors associated with survival, and peritonitis incidence in PD patients who commenced PD at our center since 1990.
METHODS
We investigated 670 patients who started PD between January 1990 and June 2007. Data for sex, age, etiology of ESRD, comorbidities, follow-up duration, cause of death, and peritonitis were analyzed. Kaplan-Meier method was used to determine patient survival and technique survival rate.
RESULTS
The most common cause of death was cardiovascular disease, while peritonitis was the main reason for technique failure. The overall incidence of peritonitis between 1995 and 2007 was 0.270 episodes per patient-year, and there was a significant drop of peritonitis rate from 1995-1999 (0.365) to 2000-2007 (0.230). Patient survival after 5 and 10 years was 71.7% and 48.2% respectively. Technique survival after 5 and 10 years was 72.8% and 43.8%. Older age (age 40-59: HR 2.427, p= 0.016; age> or =60: HR 7.397, p<0.001), diabetes (HR 1.973, p=0.001), and cardiovascular disease (HR 2.040, p<0.001) were the independent risk factors of mortality, while older age (age> or =60: HR 1.791, p=0.025) and higher peritonitis rate (HR 2.361, p<0.001) were the independent risk factors of technique failure.
CONCLUSION
The patient survival, technique survival and peritonitis incidence of PD patients in our center showed outcomes comparable to other centers worldwide. Older age, diabetes, and cardiovascular disease were associated with lower patient survival, while older age and higher peritonitis rate were associated with higher technique failure.