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. 2019 Dec 22;14(2):570-577.
doi: 10.1093/ckj/sfz175. eCollection 2021 Feb.

The impact of volume overload on technique failure in incident peritoneal dialysis patients

François Vrtovsnik  1 , Christian Verger  2 , Wim Van Biesen  3 , Stanley Fan  4 , Sug-Kyun Shin  5 , Carmen Rodríguez  6 , Isabel Garcia Méndez  7 , Frank M van der Sande  8 , Tatiana De Los Ríos  9 , Katharina Ihle  9 , Adelheid Gauly  9 , Claudio Ronco  10 , James Heaf  11 ; IPOD-PD Study Group
Affiliations

The impact of volume overload on technique failure in incident peritoneal dialysis patients

François Vrtovsnik et al. Clin Kidney J. .

Abstract

Background: Technique failure in peritoneal dialysis (PD) can be due to patient- and procedure-related factors. With this analysis, we investigated the association of volume overload at the start and during the early phase of PD and technique failure.

Methods: In this observational, international cohort study with longitudinal follow-up of incident PD patients, technique failure was defined as either transfer to haemodialysis or death, and transplantation was considered as a competing risk. We explored parameters at baseline or within the first 6 months and the association with technique failure between 6 and 18 months, using a competing risk model.

Results: Out of 1092 patients of the complete cohort, 719 met specific inclusion and exclusion criteria for this analysis. Being volume overloaded, either at baseline or Month 6, or at both time points, was associated with an increased risk of technique failure compared with the patient group that was euvolaemic at both time points. Undergoing treatment at a centre with a high proportion of PD patients was associated with a lower risk of technique failure.

Conclusions: Volume overload at start of PD and/or at 6 months was associated with a higher risk of technique failure in the subsequent year. The risk was modified by centre characteristics, which varied among regions.

Keywords: bioimpedance; cohort study; fluid overload; peritoneal dialysis; technique failure.

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Figures

FIGURE 1
FIGURE 1
Selection process for the technique failure analysis population.
FIGURE 2
FIGURE 2
Cumulative incidence curves displaying the effect of fluid overload on composite endpoint and the two single components transfer to HD and death. m0, Month 0; m6, Month 6; FO, fluid overload.
See this image and copyright information in PMC

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