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Abstract: FR-PO664

Association Between Receiving Public Assistance and Long-Term Peritoneal Dialysis Outcomes in Adults

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Komukai, Daisuke, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
  • Nakajima, Yutaka, Kawasaki Clinic, Kawasaki, Kanagawa, Japan
  • Kashiwaba, Hiroshi, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
  • Suzuki, Takeshi, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
  • Kato, Ai, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
  • Uda, Susumu, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
  • Shishido, Kanji, Kawasaki Clinic, Kawasaki, Kanagawa, Japan
Background

Public assistance (PA) in Japan is available as part of the financial support system for the poor. With the increasing number of elderly people living in households, the number of elderly people receiving PA has increased. Although the role of peritoneal dialysis (PD) is substantial in the treatment of end-stage renal disease (ESRD) in the elderly, the effects of the long-term PD on PA recipients remain unknown.

Methods

We reviewed medical records for 147 patients who had initiated PD between 2005 and 2018 at Kawasaki Saiwai Hospital and had remained in care at a related facility. We examined patient characteristics, including age, sex, ESRD etiology, and serum creatinine and albumin levels at the PD induction. Data on PD prescription and the method of connection were also collected. The long-term technical survival and peritonitis-free survival rates were calculated using Kaplan–Meier method, and predictors of technical and peritonitis-free survival were determined using Cox regression analysis.

Results

PD was initiated in 88 males and 59 females, of which 18 received PA. At the induction, mean patient age was 63.1 years and mean estimated glomerular filtration rate (eGFR) was 5.9 ml/min/1.73m2. In the Kaplan–Meier analysis, the overall median time for technical survival was 1158 days: 806 days for the recipients and 1357 days for non-recipients. Although there was no statistical difference in the technical survival rate between the two groups, the outcome appeared to be unfavorable in the PA recipients. The peritonitis-free survival was significantly shorter in the PA recipients than in the non-recipients.
In Cox regression analysis, PA was associated with short technical [HR 2.16; 95%CI 1.06–4.40] and peritonitis-free survival [HR 3.13; 95%CI 1.55–6.34] after adjustments for age, sex, estimated GFR at the induction, the presence of diabetes, connection method, and the presence of people living together.

Conclusion

Receiving PA was associated with unfavorable technical survival outcomes and significantly poor peritonitis-free survival outcomes.