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Abstract: FR-PO524

Timing of Peritoneal Dialysis Initiation and Mortality: A Retrospective Clinical Study

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Peng, Yuan, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  • Xiao, Xi, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  • Huang, Xuan, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  • Wu, Meiju, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
  • Yu, Xueqing, Department of Nephrology, Guangdong Provincial People's Hospital, Guangzhou, China
  • Yang, Xiao, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Background

The impact of timing of peritoneal dialysis (PD) initiation on mortality is controversial. We conduct this study to investigate the association between timing of PD initiation and mortality.

Methods

In this single-center cohort study, incident PD patients from January 1, 2006, to December 31, 2016 were enrolled. All patients were followed up until December 31, 2018. Patients were categorized into 3 groups according to the estimated glomerular filtration rate (eGFR) at the initiation of PD using the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation. Defined early, mid, and late starts as eGFR ≥ 7.5, 5-7.5 and < 5 ml/min/1.73 m2, respectively. Cox regression analysis was used to compare mortality (overall and cardiovascular [CV]) among the 3 groups.

Results

A total of 2,151 incident PD patients were enrolled. The number of patients in early group was 319, mid group was 726, and late group was 1,106. Compared with the early-start group, the overall and CV mortality rates were not lower for the mid- (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.69-1.12 and HR 0.89, 95% CI 0.63-1.25) or late-start (HR 0.82, 95% CI 0.64-1.05 and HR 0.78, 95% CI 0.55-1.11) groups. In age-stratified model, elderly patients (age≥65 years) showed a significant lower risk of overall and CV mortality in late-start group (HR 0.65, 95% CI 0.45 – 0.95 and HR 0.50, 95% CI 0.30-0.83) and a significant decreased risk of CV mortality in mid-start group (HR 0.55, 95% CI 0.33-0.92) compared with early-start group; however, there was no significant difference in overall or CV mortality between the 3 groups in younger patients (<65 years).

Conclusion

Lower eGFR at PD therapy initiation was not associated with lower mortality risk. However, an eGFR < 5 ml/min/1.73m2 at the initiation of PD was associated with lower risk of mortality among elderly patients, while not among younger patients.