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Abstract: PO0972

Technique Failure in the Dominican Republic National Peritoneal Dialysis Program

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Campos, Erwin I., Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Cuevas Budhart, Miguel Angel, Instituto Mexicano del Seguro Social, Ciudad de Mexico, DF, Mexico
  • Polanco, Elianny S., Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Collado, Jhanna H., Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Aquey, Mercedes, Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Guzman Chavez, Janny, Baxter Colombia, Bogota, Bogota, Colombia
  • Ramos, Alfonso, Baxter Mexico, Ciudad de México, Ciudad de México, Mexico

Group or Team Name

  • Macrotech
Background

Technique failure is a critical concern in peritoneal dialysis (PD), and it's associated with significant risk of patient lost. Technique failure is defined as transfer to HD 30 days after initiation of therapy or death within 30 days of transfer to HD.

Methods

This is a retrospective multicenter observational cohort study of incident Peritoneal Dialysis patients conducted between January 1st 2016 to December 31st 2020. Competing risk events were death and kidney transplantation, and patients were censored for recovery of kidney function, withdrawal or suspension of the therapy, and loss of a caregiver. Disease characteristics and baseline demographics were included. Data are expressed as mean ± standard deviation for continuous variables and as frequency counts and percentages for categorical variables. Incidence rates were performed for transfer to HD and finally, logistic regression analysis between the inferential type variables to determine the risk between having a history of diabetes mellitus and the variables of death and transfer to HD were calculated using an Odds Ratio analysis with 95% confidence intervals for parameters B.

Results

A total of 2326 patients were included, 59% men; the mean age was 57 + 16 years, 53% had a diagnosis of Diabetes Mellitus (DM) and 65% had a basic educational level. 151 patients were censored (11%). Risk events were 1096 of which death accounts for 1084 (74%) and transplantation (0.8%). At the end of the first year, the cumulative incidence risk to HD transfer was 1%, the second year 4%, the third year 6%, the fourth 11%, and the fifth 16%. Based on the regression analysis between the variables of interest and the patients with a history of DM, there is a higher risk of death (p<0.001; OR. 2.123; CI 95% 1.781-2.532), however, for transfer to HD, no statistical significance was found (p=0.39; OR 1.14; CI 95% 0.838-1.564). The most frequent reason for technique failure was psychosocial and medical conditions 44%, followed by catheter malfunction 30%, peritonitis 13% and ultrafiltration failure 13%.

Conclusion

The technique failure rate is similar to the reported in RTS Colombian PD Program, but better than the mean of Latin American countries reports. Still, Improvement needs to be done in the catheter implant technique and mortality rates.