Background: The use of peritoneal dialysis (PD) as a treatment modality for patients with end-stage renal disease (ESRD) has been declining in many countries over the past few years. One of the reasons is technique failure, which occurs more frequently than is the case with chronic haemodialysis. Identifying and addressing the causes of technique failure is important in order to maintain more patients on PD, especially in settings where there are limited resources for chronic haemodialysis and a "PD first" approach is followed. Methods: In this retrospective study at Tygerberg Hospital in Cape Town, South Africa, we investigated 170 patients who were started on chronic ambulatory PD between January 2008 and July 2014, and determined rates of technique and patient survival. Demographic, clinical and laboratory data were assessed to identify risk factors for these outcomes. Results: The median age of the patients was 36 years and the most common cause of ESRD was glomerulonephritis. Only one patient had diabetes mellitus. Technique survival at 1, 3 and 5 years was 80%, 54% and 39%, respectively, while patient survival was 90%, 82% and 63%. Patients started on PD during the second half of the study period had improved rates of technique survival. Peritonitis was the most common cause of technique failure. Increasing age and Black ethnicity were associated with increased likelihood of technique failure. Other clinical and social factors were not significantly associated with the occurrence of technique failure. Conclusions: In our patients on PD, peritonitis, increased age and Black ethnicity were important factors associated with the development of technique failure. Concerted efforts are required to reduce peritonitis rates at our centre as this is the leading cause of technique failure.

Pregnancy outcomes in patients on chronic dialysis have improved as a result of the intensification of dialysis and improved perinatal care. We report the successful outcome of a pregnancy in a patient on chronic haemodialysis in Cape Town, South Africa. With intensification of her therapy using thrice-weekly, nocturnal haemodialysis the pregnancy was maintained until 34 weeks at which time a 1.86 kg baby boy was delivered by elective caesarean section. One year later the patient was doing well on maintenance haemodialysis and the baby was achieving his developmental milestones. This report highlights our ability to employ a multi-disciplinary approach and prolonged, nocturnal haemodialysis to support pregnant dialysis patients in the South African setting and achieve good outcomes for both mother and baby.

New Onset Diabetes after Transplantation (NODAT) is a common complication of renal transplantation worldwide. However, there is very little data available regarding this condition in Sub-Saharan Africa. This study was therefore conducted in order to determine the incidence of NODAT and its associated risk factors in a South African renal transplant population. A retrospective analysis was conducted on 221 patients who underwent renal transplants at Tygerberg Hospital during the period January 1st 1995 to December 31st 2008.