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Abstract: FR-PO509

Peritoneal Dialysis Outcomes of Patients with Nephrotic Syndrome: A Propensity Matched Study

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Zhou, Sijia, Peking University Third Hospital, Beijing, China
  • Tang, Wen, Peking University Third Hospital, Beijing, China
Background

Whether or not nephrotic syndrome (NS) patients developed to end stage renal disease (ESRD) stage could be treated by peritoneal dialysis (PD) were not clear. The aim of this study is to investigate the outcomes of PD treatment on ESRD patients with or without NS.

Methods

In this retrospectively cohort study, all incident PD patients with NS who started PD during February 1, 2006, to December 31, 2017, were identified and matched with patients who without NS by using propensity scores based on age, gender, diabetes mellitus and serum albumin. Both the mortality and technique failure on PD were compared.

Results

A total of 53 NS PD patients and 53 matched control non-NS PD patients with a median follow-up of 3.32(0.84, 5.95) years were included. The median survival of NS PD patients (6.60 years, 95% CI 4.95-8.25 years) was comparable to that of non-NS PD patients (5.20 years, 95% CI 4.05-6.34 years, p=0.261). An interaction effect was observed between survival time and baseline NS status. Thus, patients' outcomes within 1.5 years and after 1.5 years were analyzed separately. Both the mortality rate (log-rank test, p=0.235) and technique failure (log-rank test, p=0.543) within 1.5 years in the patients with NS were comparable to those of non-NS group. However, after 1.5 years, as compared to patients without NS, NS status at baseline had both lower all-cause mortality (p=0.020) and lower technique failure rate on PD (p=0.008). Multivariable Cox regression analysis showed that as compared to non-NS patients, PD patients with NS (HR 0.38, 95% CI 0.17-0.86, p=0.019) were significantly associated with both lower all-cause mortality adjusting for age (HR 1.05, 95% CI 1.02-1.08, p<0.001) and serum albumin levels at baseline (HR 0.86, 95% CI 0.75-1.00, p=0.047) and lower technique failure rate after adjusting for age (HR 1.03, 95% CI 1.00-1.05, p=0.020) and hypertension.

Conclusion

Our study demonstrated that both the short and long-term PD outcomes of ESRD NS patients were not inferior to their matched control, which indicated that PD could be considered as a long-term renal replacement therapy for ESRD patients with baseline NS.