Early technique failure in peritoneal dialysis patients in a multi-ethnic Asian country
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NEPHROLOGY - ORIGINAL PAPER
Early technique failure in peritoneal dialysis patients in a multi‑ethnic Asian country Riece Koniman1 · Marjorie Wai Yin Foo1 · David W. Johnson2,3,4,5 · Sin Yan Wu1 · Ying Hao6 · Mathini Jayaballa1 · Chee Chin Phang1 · Elizabeth Ley Oei1 · Htay Htay1 Received: 12 April 2020 / Accepted: 7 July 2020 © Springer Nature B.V. 2020
Abstract Purpose Early technique failure is a serious complication for peritoneal dialysis (PD) patients. The study aimed to examine the incidence, causes, and risk factors associated with early technique failure. Methods This retrospective study included all incident PD patients in a hospital in Singapore from 2013 to 2017. The primary outcome was early technique failure, which was defined as transfer to hemodialysis for ≥ 30 days or death, within the first year of PD initiation. Secondary outcomes were death, technique failure due to PD infection, and death-censored technique failure. Results Overall, 517 patients were included in the study. Of these, 98 patients (19.0%) developed early technique failure. The common causes of early technique failure were death (41.8%) and infection (40.8%). Peripheral vascular disease was significantly associated with a higher hazard of early technique failure [hazard ratio (HR) 1.95, 95% confidence interval (CI) 1.04–3.63] and death (HR 3.75, 95% CI 1.71–8.21), whilst glomerulonephritis as a cause of end-stage kidney disease (compared with hypertension) was associated with a lower hazard of early technique failure (HR 0.38, 95% CI 0.18–0.77) and death (HR 0.08, 95% CI 0.02–0.37). Male gender was associated with early technique failure due to PD infection (HR 2.55, 95% CI 1.32–4.95). No specific factor was associated with death-censored early technique failure. Conclusion Technique failure in the first year of PD initiation occurs in one-fifth of PD patients and is associated with peripheral vascular disease and cause of end-stage kidney disease. Keywords Early technique failure · First-year technique survival · Peritoneal dialysis · Transfer to hemodialysis
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11255-020-02570-3) contains supplementary material, which is available to authorized users. * Htay Htay [email protected] 1
Department of Renal Medicine, Academia, Singapore General Hospital, Level 3, 20 College Road, Singapore 169856, Singapore
2
Princess Alexandra Hospital, Brisbane, Australia
3
Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia
4
Translational Research Institute, Brisbane, Australia
5
Metro South and Ipswich Nephrology and Transplant Services (MINTS), Brisbane, Australia
6
Singapore Health Services, Health Services Research Centre (HSRC), Singapore, Singapore
Technique failure is a significant complication of peritoneal dialysis (PD), and is associated with increased risks of morbidity, mortality, and healthcare costs. The risk for technique failure is highest within the fir
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