|
Title Incidence, causes and predictors of early technique failure in peritoneal dialysis patients: A single center experience |
|
Type Poster Presentation |
|
Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
|
Topic Dialysis: Peritoneal Dialysis |
|
Main Author Riece Koniman1 |
|
Presenting Author Riece Koniman1 |
|
Co-Author Foo Wai Yin Marjorie1 Wu Sin Yan1 Ng Peishi1 Mathini Jayaballa1 Oei Ley Elizabeth1 Htay Htay1 |
|
Department / Institution / Country Renal Medicine / Singapore General Hospital / Singapore1 |
|
Abstract Content: Introduction, Method, Result, Conclusion Background: The risk for technique failure is highest within first year of peritoneal dialysis (PD) initiation and is associated with morbidity and mortality. We aimed to examine the incidence, causes and risk factors associated with early technique failure. Methods: All incident PD patients from the year 2013 to 2017 in Singapore General Hospital were included in this retrospective study. Primary outcome was early technique failure, defined as transfer to haemodialysis for ≥ 30 days or death, within first year of PD initiation. Secondary outcomes were cause-specific early technique failure. Cox proportional hazards model was used to predict risk factors associated with early technique failure. Results: Of 517 incident PD patients included, 98 (19.0%) developed early technique failure. All-cause death (n=41;41.8%) and PD-related infection (n=40;40.8%) were most common causes of early technique failure. Age (62.4±13.7 versus 61.2 ±14.1 years), male gender (47.4% versus 44.4%), Chinese race (70.4% versus 74.2%), body mass index (24.4±4.5 versus 24.4±4.8 Kg/m2), diabetes (62.2% versus 60.9%), ischaemic heart disease (43.9% versus 37.5%), stroke (10.2% versus 11.2%) and use of automated PD (69.9% versus 71.6%) were not significantly different between patients with and without early technique failure. The early technique failure group had higher incidence of peripheral vascular disease (13.3% versus 6.7%), diabetes nephropathy (59.8% versus 54.7%) and hypertensive nephropathy (16.5% versus 8.6%), and lower incidence of glomerulonephritis (17.5% versus 29.1%) and polycystic kidney disease (0 versus 3.6%) compared with those without early technique failure. In multivariable Cox regression analysis, age (HR 1.01, 95% CI 1.00-1.02) and peripheral vascular disease (HR 2.37, 95% CI 1.61-3.48) were significantly associated with early technique failure. Conclusion: There was appreciable proportion of early technique failure. Death and PD-related infection were the most common causes. Further prospective studies are needed to examine risk factors for early technique failure and strategies to prevent it.
|