Abstract: FR-PO0537
Impact of Transition Timing to Peritoneal Dialysis on Clinical Outcomes
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Htay, Htay, Singapore General Hospital, Singapore, Singapore
- Foo, Marjorie Wai Yin, Singapore General Hospital, Singapore, Singapore
- Gan, Sheryl Shien Wen, Singapore General Hospital, Singapore, Singapore
- Jayaballa, Mathini, Singapore General Hospital, Singapore, Singapore
- Johnson, David W., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Lwin, Khin Zar Li, Singapore General Hospital, Singapore, Singapore
- Oei, Elizabeth Ley, Singapore General Hospital, Singapore, Singapore
- Wang, Angela Yee Moon, Singapore General Hospital, Singapore, Singapore
- Tan, Chieh-suai, Singapore General Hospital, Singapore, Singapore
Background
Patients requiring dialysis may start with peritoneal dialysis (PD) directly or initiate temporary hemodialysis (HD) before transitioning to PD. This study evaluated the impact of PD transition timing on outcomes.
Methods
This retrospective single-center study included adult PD patients from 2005 to 2015, categorized into three groups: PD-first (directly initiated on PD), Rapid PD Transition (initiated temporary HD with PD catheter insertion ≤2 weeks), and Delayed PD Transition (initiated HD with PD catheter insertion >2 weeks but ≤6 months). The primary outcome was all-cause death and secondary outcomes were bacteremia, peritonitis, hospitalization, and transfer to HD.
Results
The study included 807 PD patients: 257 (32%) in the PD-first, 169 (21%)_in Rapid PD transition, and 381 (47%) in delayed PD transition. Median HD duration before PD catheter insertion was 7 days (IQR: 3–10) for rapid and 43 days (IQR: 27–76) for delayed PD transition. The delayed PD transition group was more likely to have diabetes and cardiovascular disease and were less likely to be seen by nephrologists before dialysis than the PD-first group. All-cause death was significantly more frequent in the delayed PD transition group than in the PD-first group after adjusting for comorbidities (adjusted hazard ratio [AHR] 1.42; 95% CI 1.15–1.77). However, no significant difference in mortality was found between the PD-first and rapid PD transition groups. Patients in the delayed PD transition group had higher odds of bacteremia than the PD-first group (adjusted odds ratio [AOR] 2.08; 95% CI 1.46–2.99), but no such association in the rapid PD transition group. Time to the first episode of bacteremia was shorter in the rapid and delayed PD transition groups than in PD-first group. Hospitalization rates were higher in the rapid and delayed PD transition groups, while peritonitis and HD transfer were similar across the three groups.
Conclusion
Delayed PD transition was significantly associated with higher risks of bacteremia, hospitalization, and all-cause death compared to PD-first. Future multicenter studies should validate these findings.