Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey
Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey
Background/aim: The aim of this study was to evaluate the clinical outcomes and identify the predictors of mortality in peritonealdialysis patients.Materials and methods: Medical records of all incident peritoneal dialysis (PD) patients followed up between January 2011 and May2019 were reviewed retrospectively. All patients were followed up until death, renal transplantation, transfer to haemodialysis or theend of the study.Results: A total of 242 patients were included in the study. The incidence of peritonitis was 0.18 (ranging from 0 to 14.9) episodes perpatient year. Death occurred in 28% (n: 68) of cases. Age, diabetes mellitus, malignancy and refractory heart failure were independentrisk factors for all-cause mortality according to multivariate analysis. The presence of comorbid disease and diabetes mellitus and patientsaged > 65 years were associated with increased risk of mortality and decreased patient survival. Peritonitis history was associated withincreased risk of mortality. Between peritonitis and peritonitis-free group, there was no significant difference in Kaplan-Meier curvesin terms of patient survival.Conclusion: This is the first study to define 9-year mortality predictors in PD patients in our centre. Although peritonitis is the mostfeared complication of PD, our study showed that peritonitis did not reduce patient survival.
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- 1. Liu FX, Gao X, Inglese G, Chuengsaman P, Pecoits-Filho R et
al. A global overview of the impact of peritoneal dialysis first or
favored policies: an Opinion. Peritoneal Dialysis International
2015; 35 (4): 406-420. doi: 10.3747/pdi.2013.00204
- 2. Grassmann A, Gioberge S, Moeller S, Brown G. ESRD patients
in 2004: global overview of patient numbers, treatment
modalities and associated trends. Nephrology Dialysis
Transplantation 2005; 20 (12): 2587-2593.
- 3. Daly CD, Campbell MK, MacLeod AM, Cody DJ, Vale LD et
al. Do the Y-set and double-bag systems reduce the incidence
of CAPD peritonitis? A systematic review of randomized
controlled trials. Nephrology Dialysis Transplantation 2001;16
(2): 341-347.
- 4. Flayou K, Ouzeddoun N, Bayahia R, Rhou H, Benamar L.
Mechanical complications of continuous ambulatory peritoneal
dialysis: experience at the Ibn Sina University Hospital. Saudi
Journal of Kidney Diseases and Transplantation 2016; 27 (1):
107-110.
- 5. Lee JH, Park SH, Lim JH, Park YJ, Kim SU et al. Impact of
dialysis modality on technique survival in end-stage renal
disease patients. Korean Journal of Internal Medicine 2016; 31
(1): 106-115.
- 6. Mizuno M, Ito Y, Suzuki Y, Sakata F, Saka Y et al. Recent
analysis of status and outcomes of peritoneal dialysis in the
Tokai area of Japan: the second report of the Tokai peritoneal
dialysis registry. Clinical and Experimental Nephrology 2016;
20 (6): 960-971.
- 7. Peng Y, Yang X, Chen W, Yu XQ. Association between timing
of peritoneal dialysis initiation and mortality in end-stage
renal disease. Chronic Diseases and Translational Medicine
2018;5 (1): 37-43.
- 8. Lasfar LB, Guedri Y, Zellama D, El Meknassi I, Azzebi A et al.
Long-term clinical outcomes of peritoneal dialysis patients:
10-year experience of a single unit from Tunisia. Saudi Journal
Kidney Disease Transplantation 2019;30 (2): 451-461.
- 9. Vikrant S. Long-term clinical outcomes of peritoneal dialysis
patients: 9-year experience of a single center from north India.
Peritoneal Dialysis International 2014; 34 (4): 426-433.
- 10. Jaar BG, Plantinga LC, Crews DC, Fink NE, Hebah N et al.
Timing, causes, predictors and prognosis of switching from
peritoneal dialysis to hemodialysis: a prospective study. BMC
Nephrology 2009;10: 3.
- 11. Gray NA, Grace BS, McDonald SP. Peritoneal dialysis in rural
Australia. BMC Nephrology 2013;14: 278. doi: 10.1186/1471-
2369-14-278
- 12. Süleymanlar G, Ateş K, Seyahi N. Registry of the Nephrology,
Dialysis and Transplantation in Turkey, Registry 2017. Ankara,
Turkey: Miki press; 2018.
- 13. Erek E, Süleymanlar G, Serdengeçti K, Altıparmak MR,
Seyahi N et al. Registry of the Nephrology, Dialysis and
Transplantation in Turkey. İstanbul, Turkey: Turkish Society of
Nephrology; 2008.
- 14. Shahbaz H, Gupta M. Creatinine Clearance. St Petersburg, FL,
USA: StatPearls Publishing; 2019.
- 15. Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S et al. ISPD
Peritonitis Recommendations: 2016 Update on Prevention and
Treatment. Peritoneal Dialysis International 2016;36 (5): 481-
508.
- 16. Piraino B, Bernardini J, Brown E, Figueiredo A, Johnson DW et
al. ISPD position statement on reducing the risks of peritoneal
dialysis-related infections. Peritoneal Dialysis International
2011; 31 (6): 614-630.
- 17. Sakacı T, Ahbap E, Koc Y, Basturk T, Ucar ZA et al. Clinical
outcomes and mortality in elderly peritoneal dialysis patients.
Clinics (Sao Paulo) 2015; 70 (5): 363-368. doi: 10.6061/
clinics/2015(05)10
- 18. Abe M, Hamano T, Hoshino J, Wada A, Nakai S et al. Predictors
of outcomes in patients on peritoneal dialysis: A 2-year
nationwide cohort study. Scientific Reports 2019; 9 (1): 3967.
doi: 10.1038/s41598-019-40692-6
- 19. Remón-Rodríguez C, Quirós-Ganga P, Portolés-Pérez J,
Gómez-Roldán C, Miguel-Carrasco A et al. Grupo Cooperativo
Registros Españoles de Diálisis Peritoneal. [Results of the
cooperative study of Spanish peritoneal dialysis registries:
analysis of 12 years of follow-up]. Nefrologia 2014; 34 (1): 18-33.
- 20. Grossekettler L, Schmack B, Meyer K, Brockmann C,
Wanninger R et al. Peritoneal dialysis as therapeutic option in
heart failure patients. ESC Heart Failure 2019;6 (2): 271-279.
- 21. Kavanagh D, Prescott GJ, Mactier RA. Peritoneal dialysisassociated
peritonitis in Scotland (1999-2002). Nephrology
Dialysis Transplantation 2004; 19 (10): 2584-2591.
- 22. Teixeira JP, Combs SA, Teitelbaum I. Peritoneal dialysis: update
on patient survival. Clinical Nephrology 2015;83 (1): 1-10.
- 23. Ye H, Zhou Q, Fan L, Guo Q, Mao H et al. The impact of
peritoneal dialysis-related peritonitis on mortality in peritoneal
dialysis patients. BMC Nephrology 2017;18 (1): 186.
- 24. Mujais S, Story K. Peritoneal dialysis in the US: evaluation
of outcomes in contemporary cohorts. Kidney International
Supplementary 2006; 103: S21-S26.
- 25. Tsujikawa H, Tanaka S, Matsukuma Y, Kanai H, Torisu K et al.
Development of a risk prediction model for infection-related
mortality in patients undergoing peritoneal dialysis. PLoS One
2019; 14 (3): e0213922.
- 26. Tabibi H, As’habi A, Najafi I, Hedayati M. Prevalence of
dynapenic obesity and sarcopenic obesity and their associations
with cardiovascular disease risk factors in peritoneal dialysis
patients. Kidney Research and Clinical Practice 2018; 37 (4):
404-413.
- 27. Wang H, Tian J, Du F, Wang T. Effect of peritoneal transport
characteristics on clinical outcome in nondiabetic and diabetic
nephropathy patients with peritoneal dialysis. Iranian Journal
of Kidney Disease 2019; 13 (1): 56-66.