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Perit Dial Int 28(3): 238-245 2008
© 2008 International Society for Peritoneal Dialysis
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ORIGINAL ARTICLES

PATIENT AND TECHNIQUE SURVIVAL AND FACTORS AFFECTING MORTALITY ON PERITONEAL DIALYSIS IN TURKEY: 12 YEARS' EXPERIENCE IN A SINGLE CENTER

Murat Hayri Sipahioglu, Aysun Aybal, Aydin Ünal, Bulent Tokgoz, Oktay Oymak and Cengiz Utas

Department of Nephrology, Medical Faculty, Erciyes University, Kayseri, Turkey

Correspondence to: M.H. Sipahioglu, Erciyes Universitesi, Tip Fakultesi, Nefroloji Bilim Dali, Kayseri, Turkey.
murathsipahioglu{at}yahoo.com

{diamondsuit} Background: We investigated patient and technique survival and factors affecting mortality in Turkish peritoneal dialysis (PD) patients.

{diamondsuit} Patients and Methods: This was a retrospective study. 423 PD patients were included. The demographic, clinical, and biochemical data were collected from the medical records. Clinical outcomes were mortality and technique failure.

{diamondsuit} Results: Mean age at the start of PD was 46.0 ± 14.3 years and mean PD duration was 37.1 ± 28.3 (median: 30, range: 4-137) months. Diabetes mellitus was the most common cause of end-stage renal disease (35.2%), followed by hypertension (14.7%). There were 89 (21.0%) deaths. 25 (5.9%) patients received a kidney transplant, 74 (17.4%) patients were transferred to hemodialysis. Estimation of technique survival by Kaplan-Meier was 96.1%, 83.2%, 67.6%, 45.8%, and 33.6% at 1, 3, 5, 8, and 10 years. Technique failure was associated with peritonitis rate [relative risk (RR): 3.22, p < 0.001] and peritoneal Kt/V urea (RR: 0.38, p = 0.001) in the Cox proportional hazards model analysis. Estimation of patient survival by Kaplan-Meier was 96.9%, 83.8%, 68.8%, 50.2%, and 40.7% at 1, 3, 5, 8, and 10 years, respectively. In the Cox proportional hazards model analysis, age (RR: 1.01, p = 0.05), transfer to PD from hemodialysis (RR: 1.84, p = 0.03), comorbid cardiovascular disease (RR: 1.90, p = 0.004), serum creatinine level (RR: 0.75, p < 0.001), total Kt/V urea (RR: 0.34, p < 0.001), peritonitis rate (RR: 1.87, p < 0.001), and dialysate-to-plasma creatinine ratio (RR: 6.49, p = 0.04) predicted mortality.

{diamondsuit} Conclusions: Even though we cannot conclude with certainty that survival rates in Turkish patients are better than those in the United States and Europe, our results seem to suggest this and warrant further studies adjusted for more extensive demographic features and comorbidities. The factors affecting mortality in Turkish PD patients are similar to other populations.

KEY WORDS: Survival; technique survival; mortality factors; Turkey.

Received 10 February 2008; accepted 3 March 2008.






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