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Perit Dial Int 29(3): 292-296
2009
© 2009 International Society for Peritoneal Dialysis
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Clinical

TECHNIQUE FAILURE AND CENTER SIZE IN A LARGE COHORT OF PERITONEAL DIALYSIS PATIENTS IN A DEFINED GEOGRAPHIC AREA

Bayode Afolalu1,2,3, Laura Troidle1,2,3, Osasu Osayimwen1, Jaya Bhargava4, Jenny Kitsen4 and Fredric O. Finkelstein1,2,3,5

Hospital of St. Raphael,1 New Haven CAPD,2 Renal Research Institute,3 Network of New England (Network #1),4 and Yale University,5 New Haven, Connecticut, USA

Correspondence to: F.O. Finkelstein, Department of Nephrology, Hospital of St. Raphael, 1450 Chapel Street, New Haven, Connecticut 06511 USA. fof{at}comcast.net

{diamondsuit} Background: Hemodialysis (HD) and peritoneal dialysis (PD) are both viable options for renal replacement therapy. Technique failure has been shown to be a major problem in PD therapy.

{diamondsuit} Objective: To examine the relationship between center size and PD technique failure.

{diamondsuit} Setting: ESRD Network #1 (NW1).

{diamondsuit} Design: Retrospective review of NW1 database.

{diamondsuit} Patients and Methods: 5003 incident PD patients between 2001 and 2005 in 105 PD units were included. Patients were grouped into 2 based on center size: group A, patients in units with ≤25 patients, and group B, patients in units with >25 patients. Outcome measures were analyzed for the first and second years of PD therapy. Patients were censored at transplantation, transfer to HD, or death.

{diamondsuit} Outcome Measures: Technique failure and mortality reported as death in Standard Information Management Systems (SIMS) database (NW1 data system).

{diamondsuit} Results: Technique failure rates were significantly higher in group A for year 1 (odds ratio: 1.36, p = 0.005) and for year 2 (odds ratio: 1.35, p = 0.03). Mortality rates were not statistically different between the 2 groups.

{diamondsuit} Conclusion: Technique failure was higher in units with ≤25 patients than in units with >25 patients. There was no difference in mortality between the 2 groups. The majority of patients in NW1 receive care in small units.

KEY WORDS: Center size; technique failure.

Received 5 May 2008; accepted 7 August 2008.




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