Treatment Outcomes and Prognostic Factors for Peritoneal Dialysis Patients Based on Single Center Experience over 18 years

Korean Journal of Nephrology 2009;28(1):19-31.

Hyun-Bae Yoon, M.D.1, Hayne Cho Park, M.D.1, Hajeong Lee, M.D.1, Seung-Suk Han, M.D.1, Sejoong Kim, M.D.2, Kwon Wook Joo, M.D.1, Yon Su Kim, M.D.1, Curie Ahn, M.D.1, Jin Suk Han, M.D.1, Suhnggwon Kim, M.D.1 and Kook-Hwan Oh, M.D.1

Department of Internal Medicine¹
Seoul National University College of Medicine Department of Internal Medicine²
Gachon University Gil Hospital

임상연구 : 최근 18년간 단일 기관 진료 자료를 바탕으로 분석한 복막투석 환자의 생존율 및 예후 인자 탐색

윤현배1, 박혜인조1, 이하정1, 한승석1, 김세중2, 주권욱1, 김연수1, 안규리1, 한진석1, 김성권1, 오국환1

서울대학교 의과대학 내과학교실1, 가천의대길병원 내과2

Abstract

Purpose:We investigated the survival rate, factors associated with survival, and peritonitis incidence in PD patients who commenced PD at our center since 1990. Methods:We investigated 670 patients who started PD between January 1990 and June 2007. Data for sex, age, etiology of ESRD, comorbidities, follow-up duration, cause of death, and peritonitis were analyzed. Kaplan-Meier method was used to determine patient survival and technique survival rate. Results:The most common cause of death was cardiovascular disease, while peritonitis was the main reason for technique failure. The overall incidence of peritonitis between 1995 and 2007 was 0.270 episodes per patient-year, and there was a significant drop of peritonitis rate from 1995-1999 (0.365) to 2000-2007 (0.230). Patient survival after 5 and 10 years was 71.7% and 48.2% respectively. Technique survival after 5 and 10 years was 72.8% and 43.8%. Older age (age 40-59: HR 2.427, p= 0.016; age≥60: HR 7.397, p<0.001), diabetes (HR 1.973, p=0.001), and cardiovascular disease (HR 2.040, p<0.001) were the independent risk factors of mortality, while older age (age≥60: HR 1.791, p=0.025) and higher peritonitis rate (HR 2.361, p<0.001) were the independent risk factors of technique failure. Conclusion:The patient survival, technique survival and peritonitis incidence of PD patients in our center showed outcomes comparable to other centers worldwide. Older age, diabetes, and cardiovascular disease were associated with lower patient survival, while older age and higher peritonitis rate were associated with higher technique failure.

Key Words: Peritoneal dialysis, Survival, Peritonitis