Abstract: PO0988
Predicting Patient and Technique Survival in a Cohort of Incident Peritoneal Dialysis (PD) Patients According to Peritoneal Small Solutes Transport Rate (PSTR)
Session Information
- Peritoneal Dialysis
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Gomez, Rafael Alberto, Baxter Renal Care Services, Cali, Colombia
- Qureshi, Abdul Rashid Tony, Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
- Stachowska-Pietka, Joanna, Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland
- Debowska, Malgorzata, Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland
- Waniewski, Jacek, Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland
- Lindholm, Bengt, Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
Background
The association between PSTR and clinical outcomes in patients undergoing chronic peritoneal dialysis (PD) is uncertain. We explored the association of PSTR with mortality and technique survival in a large cohort of incident patients undergoing PD in Colombia.
Methods
In a cross-sectional study, 8170 PD patients, treated with APD (2705, 33.1%) and with CAPD (5465, 66.9%), who underwent peritoneal equilibration test to determine dialysate/plasma creatinine ratio at 4 hours were classified into slow (16.0%), slow average (35.4%), fast average (32.9%) and fast (15.7%) PSTR categories. Demographic, clinical and laboratory variables were evaluated. During median follow-up of two years, 2633 (32.2%) patients died, 1079 (13.2%) patients transferred to hemodialysis, and 661 (8.1%) patients underwent renal transplantation. All-cause and cardiovascular disease (CVD) mortality risk and technique survival were analyzed with competing-risk regression with transplantation as competing risk.
Results
Patients with fast as compared to slow PSTR were older, more often male or diabetic (DM), and had lower Hb and serum albumin levels. In competing risk analysis, after adjusting for age, sex, body mass index, residual kidney function, presence of diabetes and hypertension and circulating albumin, Hb, and phosphate levels, higher PSTR associated with greater risk (subdistribution hazard ratio, sHR) for all-cause mortality (fast average: sHR 1.13, 95%CI 1.00-1.26; p=0.04) and fast: sHR 1.19, 95%CI 1.04-1.36; p=0.01), and CVD-related mortality (fast average: sHR 1.18, 95%CI 0.99-1.41; p=0.05) and fast: sHR 1.19, 95%CI 0.97-1.46; p=0.08), and reduced technique survival (fast average: sHR 1.15, 95%CI 0.95-1.38; p=0.13) and fast: sHR 1.24, 95%CI 0.99-1.54; p=0.05).
Conclusion
These results suggest that fast and fast average PSTR associates with increased mortality risk and tendency towards reduced technique survival when analyzed using adjusted competing-risk regression models.
Funding
- Commercial Support –