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Abstract: FR-PO493

Peritoneal Small Solute Transfer Rate (PSTR) vs. Clinical Outcome in Peritoneal Dialysis Patients: Assessment by Restricted Mean Survival Times (RMST)

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Gomez, Rafael Alberto, Servicio de Terapia Renal Cali SAS, Cali, Cali , Colombia
  • Lindholm, Bengt, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Qureshi, Abdul Rashid Tony, Karolinska Institutet, Stockholm, Stockholm, Sweden

Fast PSTR is in most studies linked to worse outcomes. To explore the impact of PSTR on clinical outcomes in patients undergoing chronic peritoneal dialysis (PD) in Colombia, we analyzed RMST, a robust and clinically interpretable measure that quantifies the entire observed survival curve.


In a cross-sectional study using peritoneal equilibration test (PET), 8170 prevalent PD patients, 2705 on APD and 5465 on CAPD, were classified by PSTR according to Twardowski method into slow (16.0%), slow average (35.4%), fast average (32.9%) and fast (15.7%) PSTR categories. Demographic and clinical variables were recorded. During follow-up for a median of 1.99 years, 2633 patients died, and 661 patients underwent renal transplantation. All-cause mortality, cardiovascular disease (CVD) mortality, and technique survival were analyzed with RMST and restricted mean time lost (RMTL), adjusting for age, sex, body mass index, albumin, Hb, phosphate, residual renal function, presence of diabetes and hypertension.


RMST analysis showed that fast PSTR as compared to slow PSTR associated with shorter patient survival due to all-cause mortality (by -0.28 years; p=0.003) or due to CVD related mortality (by -0.18 years; p=0.05 as well as shorter technique survival (by -0.22 years; p=0.03) whereas associations of fast-average PSTR with clinical outcomes were not statistically significant.


Analysis using RMST confirms that fast PSTR as compared to slow PSTR is associated with impaired patient and technique survival. However, the magnitude of the survival disadvantage (about 0.2 years) may not be clinically significant.


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