Abstract: PUB124
Reduction in Technique Failure in Peritoneal Dialysis: Analysis of Three Successive Cohorts in a National Health Program in the Dominican Republic
Session Information
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Campos, Erwin I., Macrotech, Santo Domingo, Dominican Republic
- Hernandez, Sergio, Macrotech, Santo Domingo, Dominican Republic
- Polanco, Elianny, Macrotech, Santo Domingo, Dominican Republic
- Lara, Zulma, Macrotech, Santo Domingo, Dominican Republic
- Cuevas Budhart, Miguel Angel, Unidad de investigación Médica en Enfermedades Nefrológicas, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
- Divino-Filho, Jose C., Karolinska Institutet Enheten for medicinska njursjukdomar, Huddinge, Stockholm County, Sweden
- Ramos, Alfonso, Macrotech, Santo Domingo, Dominican Republic
Group or Team Name
- Macrotech.
Background
Peritoneal dialysis (PD) is an effective renal replacement therapy. Technique failure—defined as transfer to hemodialysis (HD)—remains a major challenge. This study evaluates technique failure over three successive cohorts of incident PD patients in the Dominican Republic’s National PD Program (DRNPDP).
Methods
A retrospective cohort study was conducted, including adult incident PD patients (>18 years) with ≥90 days on therapy, from three periods: 1-1-2016–12-31-2018 (Cohort 1), 1-1-2019–12-31-2021 (Cohort 2), and 1-1-2022–12-31-2024 (Cohort 3). Clinical, demographic, and dialysis-related variables were analyzed. Outcomes included time on PD, rate of transfer to HD, and associated factors. Statistical analyses included chi-square tests, Kaplan-Meier survival analysis, and Cox regression modeling.
Results
A total of 4,339 patients were analyzed (Cohort 1: n=1,232; Cohort 2: n=1,498; Cohort 3: n=1,609). Mean age and sex distribution were similar across cohorts (p>0.05). Cohort 3 had significantly higher rates of hypertension (94.7%) and basic/intermediate education (p<0.001), and a progressive increase in automated PD (APD) usage (from 0.7% in Cohort 1 to 9.4% in Cohort 3, p<0.001).
The technique failure rate (defined as transfer to HD) decreased over time: 6.98% in Cohort 1, 6.20% in Cohort 2, and 6.27% in Cohort 3 (p<0.001). Median survival in the PD program increased progressively: 10.6, 10.9, and 11.9 months respectively (p<0.05, Tukey post hoc test). Cohort 3 showed significantly longer time on therapy compared to Cohorts 1 and 2 (p<0.001).
Conclusion
This result demonstrates a significant improvement in technique survival over time, particularly in the most recent cohort, they are associated with enhanced clinical monitoring, and the implementation of quality improvement strategies. These findings support multidisciplinary PD care models to improve patient outcomes.
Funding
- Commercial Support – Macrotech