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Kidney Week

Abstract: TH-PO319

Medication Management with Antihypertensive Agents and Associations with Peritoneal Dialysis Technique Failure in a Large, Retrospective Incident Cohort

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Kim, Billy, FreseniusRx, Franklin, Tennessee, United States
  • Kutovoy, Gennady, FreseniusRx, Franklin, Tennessee, United States
  • Warzyn, Joseph, FreseniusRx, Franklin, Tennessee, United States
  • Lee, Marissa A., FreseniusRx, Franklin, Tennessee, United States
  • Lasky, Rachel A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Ficociello, Linda, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Chatoth, Dinesh K., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
Background

The first 90 days of peritoneal dialysis (PD) have high rates of PD technique failure (TF). Although many factors determine patients’ (pts) longevity on PD, only some are potentially modifiable. Proper management of antihypertensive medications (AH-M) is one modifiable factor that may help to control blood pressure and fluid balance. We aimed to assess the association between AH-M and PD TF at 90 days.

Methods

Adult, ESKD pts first prescribed PD at Fresenius Kidney Care (FKC) facilities between 2017-2019 were included. Deidentified data were extracted from the clinical data warehouse. Medication classification was conducted by clinical pharmacists. Case-mix adjusted Cox regression models were used to evaluate the associations between AH-M and PD TF. Subanalyses were conducted based on residual renal function (RRF).

Results

Pts included (n=22,908) were often treated with AH-M (91%). There was a trend toward any AH-M being protective of PD TF (HR: 0.85, p=0.06). However, certain AH-M subclasses had stronger associations than others (Table). Treatment with any diuretic (54% of pts) was associated with 17% lower technique failure rate (p=0.001) compared to no diuretic. Subclasses of diuretics were associated with lower TF (15% for loop diuretics and 18% for other diuretics). ACEi were associated with lower rates of PD TF (19%, p=0.0047), whereas remaining subclasses showed no association. There was no association with diuretics in the pts without RRF (Table).

Conclusion

In a large population of incident PD pts, we observed that several AH-M subclasses were associated with reduced rates of PD TF after controlling for many non-modifiable case-mix variables/confounders.

Funding

  • Commercial Support – Fresenius Medical Care