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Kidney Week

Abstract: SA-PO718

Impact of Liver Cirrhosis on the Outcome of Peritoneal Dialysis

Session Information

  • Peritoneal Dialysis - II
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Jung, Young Lee, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Park, Jae Yoon, Dongguk University Ilsan Hospital, Gyeonggido, Korea (the Republic of)
  • Ryu, Hyunjin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yaerim, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Choi, Jae shin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lim, Chun Soo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Han, Seung Seok, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

Peritoneal dialysis(PD) is popular treatment modality for ESRD.However, its application to liver cirrhosis(LC) and subsequent outcomes have not been thoroughly evaluated yet.

Methods

We retrospectively reviewed 1,366 patients(≥18 yrs old) who started PD at Seoul National University Hospital between January 2000 and December 2015. Radiologic evaluation was applied to define LC at the time of PD initiation. 33 patients were assigned to LC, and their outcomes were compared with non-LC(n=35), which was selected based on the propensity score matching by age, sex, and diabetes mellitus. Primary outcome was the technical failure;secondary outcomes were peritonitis, exit site infection, and all-cause mortality.

Results

Patients were followed for a mean duration of 42.9±35.8 months. During that period, 6 patients with LC encountered technical failures, but this rate was not different from that of non-LC[Figure 1]. This difference did not alter despite adjusting several covariates, such as comorbidities and lab findings. When evaluating infection, common causes for peritonitis and exit site infection were E.coli(5.8%) and S.aureus(19.3%); these rates were not different from those of non-LC. Overall mortality were similar between LC and non-LC. All of these outcomes were not dependent on severity of LC, which was quantitatively determined by Child-Pugh and MELD score. LC with hepatocellular carcinoma(n=6) did not have inferior outcomes including mortality to counterpart group without carcinoma.

Conclusion

The presence of LC and its severity did not affect subsequent outcomes in patients starting PD. Based on the fact that trials with randomization of dialysis modality are not feasible, the present observational results may provide reassurance to the LC starting PD.

Figure 1. Technical failure-free survival curves between LC and non-LC patients