Predicting One-Year Mortality in Peritoneal Dialysis Patients: An Analysis of the China Peritoneal Dialysis Registry

Abstract

This study aims to investigate basic clinical features of peritoneal dialysis (PD) patients, their prognostic risk factors, and to establish a prognostic model for predicting their one-year mortality. A national multi-center cohort study was performed. A total of 5,405 new PD cases from China Peritoneal Dialysis Registry in 2012 were enrolled in model group. All these patients had complete baseline data and were followed for one year. Demographic and clinical features of these patients were collected. Cox proportional hazards regression model was used to analyze prognostic risk factors and establish prognostic model. A validation group was established using 1,764 new PD cases between January 1, 2013 and July 1, 2013, and to verify accuracy of prognostic model. Results indicated that model group included 4,453 live PD cases and 371 dead cases. Multivariate survival analysis showed that diabetes mellitus (DM), residual glomerular filtration rate (rGFR), , SBP, Kt/V, high PET type and Alb were independently associated with one-year mortality. Model was statistically significant in both within-group verification and outside-group verification. In conclusion, DM, rGFR, SBP, Kt/V, high PET type and Alb were independent risk factors for short-term mortality in PD patients. Prognostic model established in this study accurately predicted risk of short-term death in PD patients.

Fibrinogen/Albumin ratio: A more powerful prognostic index for patients with end‐stage renal disease

“…In addition, the other inflammatory markers were higher in the high FAR group. After adjusting for other factors, the Cox regression analysis showed that age, diabetes, hs‐CRP and total Kt/V were associated with mortality in PD patients, which is consistent with previous studies 19,20 . We further analysed the interaction among the FAR and other factors.…”

Membrane transport status does not predict peritonitis risk in patients on peritoneal dialysis

“…Our finding that smoking was associated with mortality also remains consistent with previous literature, 28,34,35 which may be because smoking confers increased cardiovascular risk, as seen by the higher rates of congestive cardiac failure, peripheral vascular disease in smokers on dialysis. 36 Our study was neither powered nor designed to examine specific causes of mortality.…”

“…The association of age and diabetes mellitus with patient survival on PD is consistent with other studies, suggesting that these factors have clinical significance in predicting prognosis of PD patients. An association between smoking status and peritonitis has been noted in previous literature, which may be because cigarette smoke affects both cell‐mediated and humoral‐mediated immune responses, thereby increasing risk of infection .…”

Development of a risk prediction model for infection-related mortality in patients undergoing peritoneal dialysis

“…Several risk scores for predicting all-cause mortality and cardiovascular mortality in patients undergoing dialysis have been reported previously [ 13 – 19 ]. One study has already developed and validated a risk model for cardiovascular mortality in patients undergoing PD.…”

“…Prediction models for predicting the risk of all-cause and cardiovascular mortality among patients undergoing hemodialysis and PD have recently been developed [ 13 – 19 ]. However, there has been limited research regarding infection-related death in patients undergoing PD.…”