Ten-year survival of patients treated with peritoneal dialysis: A prospective observational cohort study

Abstract

Background: Few studies evaluated over 5-year outcomes of dialysis patients. This study examined 10-year all-cause mortality and death-censored technique failure in a cohort of incident peritoneal dialysis (PD) individuals. Methods: Five hundred and thirty-three incident PD individuals from 2006 to 2008 were prospectively followed up for more than 10 years until 2018. Clinical characteristics at PD initiation were collected. The primary outcome was all-cause mortality, and the secondary outcome was death-censored technique failure. Cox hazards models were fit using clinical characteristics at PD initiation. Results: The mean age starting PD for these participants was 48 ± 16 years; 130 (24%) patients had diabetic nephropathy. During follow-up, 208 patients died, and 84 patients experienced technique failures. The 1, 3, 5, and 10 years’ survival rates for incident PD patients were 93%, 81%, 64%, and 36%, respectively, and the technical survival rates were 98%, 93%, 85%, and 62%, respectively. Mortality risk was much higher after 3 years on PD. The peritonitis rate was 0.19 episodes per patient-year, and 7 (1.3%) patients had encapsulating peritoneal sclerosis (EPS) giving an incidence rate of 3.1 of 1000 patient-years. The main causes of death were cardiovascular events (97 of 208, 47%), and technique failure was mainly due to peritonitis (41 of 84, 49%). Older age, higher Charlson comorbidity index, and lower level of education were strongly associated with mortality, and diabetic nephropathy was an independent risk factor for technique failure. Conclusions: The 10-year’s survival and technique survival rates of incident PD patients were 36% and 62%. Long-term PD can be continued successfully with improved outcomes and low risk for EPS.

Nephrologists’ perspectives on communication and decision-making regarding technique survival in peritoneal dialysis: an international qualitative interview study

“…In this study, nephrologists perceived long-term PD as around 5 years, which is consistent with definitions used in the literature 22. However, participant responses may be influenced by their clinical observations and context rather than published evidence, given that 5-year technique survival rates vary globally, from 16% in Australia to 85% in China 13 23. Participants also highlighted the differences in knowledge of PD among nephrologists, and the impact this may have on the care of patients receiving PD.…”

Vascular Calcification and the Gut and Blood Microbiome in Chronic Kidney Disease Patients on Peritoneal Dialysis: A Pilot Study

“…Adragao score measures VC and therefore may estimate CVD risk in CKD patients through hands and pelvic radiographies. Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities and has been useful in the prediction of mortality risk in CKD patients [ 73 ].…”

Establishment of a prediction model for early and mid-term complications for patients undergoing catheter insertion for peritoneal dialysis

“…Xia et al. 15 found that diabetic nephropathy was an independent risk factor for technical failure of catheterization. Many studies have also shown that diabetes mellitus is a risk factor for peritonitis after catheterization.…”

“…We found that systolic blood pressure and the rate of diabetes mellitus were significantly higher in patients with early complications than in those without early complications. Xia et al 15 found that diabetic nephropathy was an independent risk factor for technical failure of catheterization. Many studies have also shown that diabetes mellitus is a risk factor for peritonitis after catheterization.…”

“…[10][11][12] However, there have been few studies on the factors that affect postoperative complications, and most of them are limited to peritonitis. [13][14][15] Factors that are associated with overall complications after catheter insertion for peritoneal dialysis are unclear. To examine the risk factors of complications after inserting a catheter for peritoneal dialysis, we analyzed the early and mid-term complications of patients after initiating peritoneal dialysis.…”