Association between causes of peritoneal dialysis technique failure and all-cause mortality

Jenny H.C. Chen, David W. Johnson, Carmel Hawley, Neil Boudville, Wai H. Lim

Research output: Contribution to journalArticle

Abstract

Technique failure is a frequent complication of peritoneal dialysis (PD), but the association between causes of death-censored technique failure and mortality remains unclear. Using Australian and New Zealand Dialysis and Transplant (ANZDATA) registry data, we examined the associations between technique failure causes and mortality in all incident PD patients who experienced technique failure between 1989-2014. Of 4663 patients, 2415 experienced technique failure attributed to infection, 883 to inadequate dialysis, 836 to mechanical failure and 529 to social reasons. Compared to infection, the adjusted hazard ratios (HR) for all-cause mortality in the first 2 years were 0.83 (95%CI 0.70-0.98) for inadequate dialysis, 0.78 (95%CI 0.66-0.93) for mechanical failure and 1.46 (95%CI 1.24-1.72) for social reasons. The estimates from the competing risk models were similar. There was an interaction between age and causes of technique failure (pinteraction < 0.001), such that the greatest premature mortality was observed in patients aged >60 years post social-related technique failure. There was no association between causes of technique failure and mortality beyond 2 years. In conclusion, infection and social-related technique failure are associated with premature mortality within 2 years post technique failure. Future studies examining the associations may help to improve outcomes in these patients.

LanguageEnglish
Article number3980
JournalScientific Reports
Volume8
Issue number1
DOIs
StatePublished - 1 Dec 2018

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Peritoneal Dialysis
Dialysis
Premature Mortality
Mortality
Infection
Post and Core Technique
New Zealand
Registries
Cause of Death
Transplants

Cite this

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title = "Association between causes of peritoneal dialysis technique failure and all-cause mortality",
abstract = "Technique failure is a frequent complication of peritoneal dialysis (PD), but the association between causes of death-censored technique failure and mortality remains unclear. Using Australian and New Zealand Dialysis and Transplant (ANZDATA) registry data, we examined the associations between technique failure causes and mortality in all incident PD patients who experienced technique failure between 1989-2014. Of 4663 patients, 2415 experienced technique failure attributed to infection, 883 to inadequate dialysis, 836 to mechanical failure and 529 to social reasons. Compared to infection, the adjusted hazard ratios (HR) for all-cause mortality in the first 2 years were 0.83 (95{\%}CI 0.70-0.98) for inadequate dialysis, 0.78 (95{\%}CI 0.66-0.93) for mechanical failure and 1.46 (95{\%}CI 1.24-1.72) for social reasons. The estimates from the competing risk models were similar. There was an interaction between age and causes of technique failure (pinteraction < 0.001), such that the greatest premature mortality was observed in patients aged >60 years post social-related technique failure. There was no association between causes of technique failure and mortality beyond 2 years. In conclusion, infection and social-related technique failure are associated with premature mortality within 2 years post technique failure. Future studies examining the associations may help to improve outcomes in these patients.",
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Association between causes of peritoneal dialysis technique failure and all-cause mortality. / Chen, Jenny H.C.; Johnson, David W.; Hawley, Carmel; Boudville, Neil; Lim, Wai H.

In: Scientific Reports, Vol. 8, No. 1, 3980, 01.12.2018.

Research output: Contribution to journalArticle

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