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Evolving outcomes of peritoneal dialysis: secular trends at a single large center over three decades
- Evolving outcomes of peritoneal dialysis: secular trends at a single large center over three decades
- Kang, Minjung; Kim, Yae Lim; Kang, Eunjeong; Ryu, Hyunjin; Kim, Yong Chul; Kim, Dong Ki; Lee, Hajeong; Han, Seung Seok; Joo, Kwon-Wook; Kim, Yon Su; Ahn, Curie; Oh, Kook-Hwan
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- KIDNEY RESEARCH AND CLINICAL PRACTICE
- KIDNEY RESEARCH AND CLINICAL PRACTICE vol. 40, no. 3, pp. 472 - 483
- Peritoneal dialysis; Peritonitis; Survival; Technique failure
- KOREAN SOC NEPHROLOGY
- SCIE; SCOPUS; KCI
- Document Type
- Background: Peritoneal dialysis (PD) is improving as a renal replacement therapy for end-stage renal disease (ESRD) patients. We analyzed the main outcomes of PD over the last three decades at a single large-scale PD center with an established high-quality care system. Methods: As a retrospective cohort study, we included participants (n = 1,203) who began PD between 1990 and 2019. Major PD-related outcomes were compared among the three 10-year cohorts. Results: The 1,203 participants were 58.3% male with a mean age of 47.9 +/- 13.8 years. The median PD treatment duration was 45 months (interquartile range, 19-77 months); 362 patients (30.1%) transferred to hemodialysis, 289 (24.0%) received kidney transplants, and 224 (18.6%) died. Overall, the 5-and 8-year adjust patient survival rates were 64% and 49%, respectively. Common causes of death included infection (n = 55), cardiac (n = 38), and cerebrovascular (n = 17) events. The 5-and 8-year technique survival rates were 77% and 62%, respectively, with common causes of technique failure being infection (42.3%) and solute/water clearance problems (22.7%). The 5-year patient survival significantly improved over time (64% for the 1990-1999 cohort vs. 93% for the 2010-2019 cohort). The peritonitis rate also substantially decreased over time, from 0.278 episodes/patient-year (2000-2004) to 0.162 episodes/patient-year (2015-2019). Conclusion: PD is an effective treatment option for ESRD patients. There was a substantial improvement in the patient survival and peritonitis rates over time. Establishing adequate infrastructure and an effective system for high-quality PD therapy may be warranted to improve PD outcomes.
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