Outcome and Risk Factors For Mortality in Peritoneal Dialysis Patients: 20 Years Experience in a Single Turkish Center
Condition: Therapeutic Procedural Complication
Study type: Observational

Summary: 
      INTRODUCTION AND AIMS: The aims of this study were to evaluate patient and technique survival
      rates, investigate peritonitis rates and evaluate factors affecting mortality in peritoneal
      dialysis (PD) patients over a period of 20 years at Istanbul Faculty of Medicine Peritoneal
      Dialysis Unit.

      METHODS: Two hundred seventy seven patients have received PD as renal replacement therapy
      (RRT) over a period of 20 years. After exclusion of patients with follow-up shorter than 3
      months and patients whose data were not available, 250 patients were examined
      retrospectively. Data for sex, age, primary disease, comorbidities, follow up duration, cause
      of death, and cause of technique failure were collected from medical records.
    

Detailed description: 
      Material and Method All patients 18 years of age and older who were treated with PD at the
      Istanbul Medical Faculty from October 1994 to October 2014 were included in the study.
      Patients exclude which follow-up shorter than 3 months and patients whose data were not
      available. From the day PD was started, all peritonitis data were collected prospectively in
      a large database. The data include Socio-demographic data, type of peritoneal dialysis,
      starting time and duration of every peritonitis episode, causative organisms and outcome of
      the peritonitis, which could be cure, change of PD catheter, transfer to hemodialysis, or
      death. The time in months from PD start to the first episode of peritonitis was computed.

      Primary kidney disease was classified into 9 main categories according to the codes of the
      European Renal Association - European Dialysis and Transplant Association. Peritonitis in PD
      was defined as a peritoneal dialysate effluent containing >100 white blood cells/mL, of which
      >50% were polymorphonuclear leukocytes. Patients with two or more pathogens isolated from the
      cultures in a peritonitis episode were considered to have polymicrobial peritonitis. A
      relapse of peritonitis was defined when the same organism or a culture-negative peritonitis
      episode was identified within 4 weeks of completing appropriate antibiotic therapy for a
      previous episode.

      Socio-demographic, clinical and treatment characteristics, medium (standard deviation for
      continuous variables) or median (25th and 75th percentages); number for categorical variables
      (rate) were calculated. Cox regression analysis applied to examine the impact of demographic
      and clinical features of periton dialysis patients . Chi-square test for categorical
      variables used. Univariate and multivariate analyzes calculated using the Kruskal-Wallis or
      Mann-Whitney test method. P-value was <0.05 for as long as it is considered statistically
      significant. The evaluation of the results obtained using SPSS 21.0 software.
    

Intervention name(s): Peritoneal dialysis patients at the Istanbul Medical Faculty
Intervention type(s): Other
Intervention description(s): The aims of this study were to evaluate patient and technique survival rates, investigate peritonitis rates and evaluate factors affecting mortality in peritoneal dialysis (PD) patients over a period of 20 years at Istanbul Faculty of Medicine Peritoneal Dialysis Unit.
Other intervention name(s): OUTCOME AND RISK FACTORS FOR MORTALITY
Observational model: Ecologic or Community
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        Two hundred seventy seven patients have received PD as renal replacement therapy (RRT) over
        a period of 20 years.
      
Keywords: peritoneal dialysis: outcome; peritoneal dialysis: complications; peritoneal dialysis: technique; peritoneal dialysis: peritonitis