Journal
THERAPEUTIC APHERESIS AND DIALYSIS
Volume 21, Issue 5, Pages 493-499Publisher
WILEY
DOI: 10.1111/1744-9987.12546
Keywords
Hypocalcemia; Peritoneal dialysis; Predialysis indices; Technique failure
Categories
Funding
- Ministry of Health, Labour and Welfare of Japan
- Kidney Foundation of Japan
- MSD Life Science Foundation
Ask authors/readers for more resources
Technique failure remains a frequent cause of peritoneal dialysis (PD) withdrawal. Many post-commencement predictors of PD technique failure have been identified, while predialysis predictors have remained unclear. The aim of this study was to identify predialysis indices for technique failure in PD patients. We recruited 206 consecutive PD patients who were treated at Nara Medical University Hospital between 1 April 1997 and 31 December 2012. Forty-eight patients were excluded because of transition from hemodialysis (HD) or withdrawal from PD within 3 months, leaving 158 patients for analysis. Clinical characteristics and laboratory data from within 3 months preceding PD commencement were analyzed. The primary outcome was the composite of time to combined use of HD, transition to HD, and all-cause mortality within 2 years after PD commencement. During the study period, the primary outcome was observed in 50 patients. Using 95% CI], 3.08 [1.72-5.61]), anemia (ORs [95% CI], 2.12 [1.08-4.43]), overweight/obesity (ORs [95% CI], 2.09 [1.16-3.72]), and hypocalcemia (ORs [95% CI], 1.86 [1.04-3.35]) were independently associated with technique failure. Adding corrected calcium to the model incorporating age, body mass index, and hemoglobin significantly increased the c-statistic from 0.678 to 0.755 (P = 0.048) relative to the model incorporating age alone. The integrated discrimination improvement was 0.085 (95% CI 0.036-0.134, P < 0.001) and the continuous net reclassification improvement was 0.395 (95% CI 0.066-0.724, P = 0.02). In conclusion, the combination of predialysis indices comprising age, overweight/obesity, anemia, and corrected calcium could provide a significant predictive value for technique failure of PD.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available