Technique failure in Korean incident peritoneal dialysis patients: a national population-based study

Abstract

BackgroundTechnique failure is an important issue for peritoneal dialysis (PD) patients. In this study, we aimed to analyze technique failure rate in detail and to determine the predictors for technique failure in Korea.MethodsWe identified all patients who had started dialysis between January 1, 2005, and December 31, 2008, in Korea, using the Korean Health Insurance Review and Assessment Service database. A total of 7,614 PD patients were included, and the median follow-up was 24.9 months.ResultsThe crude incidence rates of technique failure in PD patients were 54.1 per 1,000 patient-years. The cumulative 1-, 2-, and 3-year technique failure rates of PD patients were 4.9%, 10.3%, and 15.6%, respectively. However, those technique failure rates by Kaplan–Meier analysis were overestimated compared with the values by competing risks analysis, and the differences increased with the follow-up period. In multivariate analyses, diabetes mellitus and Medical Aid as a crude reflection of low socioeconomic status were independent risk factors in both the Cox proportional hazard model and Fine and Gray subdistribution model. In addition, cancer was independently associated with a lower risk of technique failure in the Fine and Gray model.ConclusionTechnique failure was a major concern in patients initiating PD in Korea, especially in diabetic patients and Medical Aid beneficiaries. The results of our study offer a basis for risk stratification for technique failure.

Risk factors associated with outcomes of peritoneal dialysis in Taiwan

“…Female gender was a risk factor for technique failure in a previous report [17] ; another report indicated no gender differences in technique failure. [18] In our study, however, male gender was a risk factor for technique failure than female gender. In our institute, the selection of renal replacement therapy with either HD or PD depends on the patient's willingness and the physician's evaluation.…”

Incremental Peritoneal Dialysis May be Beneficial for Preserving Residual Renal Function Compared to Full-dose Peritoneal Dialysis

“…PD technique failure was defined as a transfer to hemodialysis and death directly related to PD-related complication. Causes of PD technique failure were as follows: peritonitis, inadequate PD, catheter complications, other abdominal or PD-related complications, and psychosocial barriers 30,31 . For analysis of time-to-technique failure, patients were censored at the time of death due to other causes, kidney transplantation, and follow-up loss.…”

Epidemiological characteristics of cancers in patients with end-stage kidney disease: a Korean nationwide study

“…Among them, 108,264 patients with special exemption codes (V001, V003, V005) were obtained. Those who had cancers prior to the ESKD diagnosis (13,432) or who developed cancers within 1 year after the index date (n = 2044) were excluded. Patients who changed RRT modalities (n = 4994), who underwent < 3 months of dialysis (12,784) or who had no treatment codes related to RRT modalities (n = 15,943) were also excluded.…”

“…The KNHIS, the single public health insurance provider in Korea, has been operated by the Ministry for Health and Welfare since July 1989 and covers over 97% of the Korean population. Many previous studies using HIRA data have been published 13 – 15 . We extracted ESKD cohort patient data from the HIRA database including characteristics such as age; sex; diagnoses based on the International Classification of Disease, Revision 10 (ICD-10) codes; intervention procedures, and surgical procedures such as HD, PD, and KT.…”