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Contribution of early failure to outcome on peritoneal dialysis

Descoeudres, Bernard and Koller, Michael T. and Garzoni, Daniela and Wolff, Thomas and Steiger, Juerg and Schaub, Stefan and Mayr, Michael. (2008) Contribution of early failure to outcome on peritoneal dialysis. Peritoneal dialysis international, Vol. 28, H. 3. pp. 259-267.

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Official URL: http://edoc.unibas.ch/dok/A6005502

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Abstract

BACKGROUND: The technique failure rate on peritoneal dialysis (PD) remains high despite technical progress. There are no data concerning the contribution of early failure to outcome on PD. Aim: To analyze the importance of early treatment failure in PD and to compare early with late failures with respect to reasons and predictors of risk for failure. METHODS: We performed a retrospective study of all patients admitted for PD from October 1983 to June 2005. The end point was PD failure-free survival. Differences between reasons for failure with respect to early (within 6 months) and late failure were analyzed. Multivariate associations of baseline covariates with early and late failure were investigated. RESULTS: We included 279 patients. 153 (55%) patients experienced PD failure: 97 (63%) of them had technique failure; 56 (37%) patients died due to non-PD-related causes. 29% (n = 44) of all PD failures and 40% (n = 39) of all technique failures occurred within 6 months. Catheter and psychosocial problems contributed more often to early than to late failure, whereas infections, leakages, and hernias contributed equally to early and late failure. Death was the predominant reason for late failure. Female sex was a risk factor for early failure and older age a risk factor for late failure. Higher cholesterol levels were associated with a decreased risk for both early and late failure. CONCLUSION: The contribution of early failure to outcome on PD is important, as one third of all PD failures and 40% of all technique failures may occur within the first 6 months, as shown in our study. Due to the retrospective nature and the single-center character, the results cannot be generalized. However, it is important to enhance recognition of patients at high risk for early PD failure prior to initiation of PD, in order to avoid unnecessary surgical interventions and medical complications, and for rational resource allocation.
Faculties and Departments:03 Faculty of Medicine > Departement Klinische Forschung > Clinical Epidemiology and Biostatistics CEB > Klinische Epidemiologie (Bucher H)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Nephrologie > Transplantationsimmunologie und Nephrologie (Steiger)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Nephrologie > Transplantationsimmunologie und Nephrologie (Steiger)
03 Faculty of Medicine > Departement Biomedizin > Former Units at DBM > Transplantation Immunology and Nephrology (Palmer/Steiger)
UniBasel Contributors:Steiger, Jürg U. and Schaub, Stefan and Koller, Michael
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Multimed
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:04 Sep 2015 14:31
Deposited On:25 Apr 2014 08:01

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