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

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• 作者：Shina Lee¹ ; Hyunwook Kim² ; Kyoung Hoon Kim³ ; Hoo Jae Hann⁴ ; Hyeong Sik Ahn⁵ ; Seung-Jung Kim¹ ; Duk-Hee Kang¹ ; Kyu Bok Choi¹ ; Dong-Ryeol Ryu¹ ; ^{drryu@ewha.ac.kr}
• 关键词：Peritoneal dialysis ; Risk factors ; Technique failure
• 刊名：Kidney Research and Clinical Practice
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：35
• 期：4
• 页码：245-251
• 全文大小：687 K
• 卷排序：35

文摘

Technique 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.