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. 2018 Mar 5;8(1):3980.
doi: 10.1038/s41598-018-22335-4.

Association between causes of peritoneal dialysis technique failure and all-cause mortality

Jenny H C Chen  1   2 , David W Johnson  3   4   5   6 , Carmel Hawley  3   4   5   6 , Neil Boudville  7   8 , Wai H Lim  7   8
Affiliations

Association between causes of peritoneal dialysis technique failure and all-cause mortality

Jenny H C Chen et al. Sci Rep. .

Abstract

Technique failure is a frequent complication of peritoneal dialysis (PD), but the association between causes of death-censored technique failure and mortality remains unclear. Using Australian and New Zealand Dialysis and Transplant (ANZDATA) registry data, we examined the associations between technique failure causes and mortality in all incident PD patients who experienced technique failure between 1989-2014. Of 4663 patients, 2415 experienced technique failure attributed to infection, 883 to inadequate dialysis, 836 to mechanical failure and 529 to social reasons. Compared to infection, the adjusted hazard ratios (HR) for all-cause mortality in the first 2 years were 0.83 (95%CI 0.70-0.98) for inadequate dialysis, 0.78 (95%CI 0.66-0.93) for mechanical failure and 1.46 (95%CI 1.24-1.72) for social reasons. The estimates from the competing risk models were similar. There was an interaction between age and causes of technique failure (pinteraction < 0.001), such that the greatest premature mortality was observed in patients aged >60 years post social-related technique failure. There was no association between causes of technique failure and mortality beyond 2 years. In conclusion, infection and social-related technique failure are associated with premature mortality within 2 years post technique failure. Future studies examining the associations may help to improve outcomes in these patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Patient flowchart for peritoneal dialysis patients who experienced peritoneal dialysis technique failure between 1989 and 2014.
Figure 2
Figure 2
Association between causes of peritoneal dialysis technique failure and all-cause mortality post peritoneal dialysis technique failure; the data is shown by the number of years following PD technique failure.
Figure 3
Figure 3
Competing risk analyses for mortality. (a) Competing risk regression for all-cause mortality 0–2 years post PD technique failure. (b) Competing risk regression for cause-specific mortality 0–2 years post PD technique failure.
Figure 4
Figure 4
Association between causes of peritoneal dialysis technique failure and cause-specific mortality 0–2 years post PD technique failure.
Figure 5
Figure 5
Proportions of cause-specific mortality 0–2 years post peritoneal dialysis technique failure stratified by age groups.
See this image and copyright information in PMC

References

    1. ANZDATA 38th Annual Report. (ANZDATA Registry, Adelaide, South Australia, Australia, 2015).
    1. Chaudhary K, Sangha H, Khanna R. Peritoneal dialysis first: rationale. Clinical journal of the American Society of Nephrology: CJASN. 2011;6:447–456. doi: 10.2215/CJN.07920910. - DOI - PubMed
    1. Caskey FC, et al. AJ. 18th Annual Report of the Renal Association. Nephron. 2016;132(suppl 1):I–XIV. - PubMed
    1. Li PK, et al. ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis. 2016;36:481–508. doi: 10.3747/pdi.2016.00078. - DOI - PMC - PubMed
    1. Lan PG, Clayton PA, Saunders J, Polkinghorne KR, Snelling PL. Predictors and outcomes of transfers from peritoneal dialysis to hemodialysis. Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis. 2015;35:306–315. doi: 10.3747/pdi.2013.00030. - DOI - PMC - PubMed