Effect of initial PET status on clinical course in peritoneal dialysis patients

Abstract

Introduction. To investigate the effect on mortality of initial peritoneal equilibration test (PET) in PD patients (pts). Methods. We included patients who initiated therapy between 2001-2014. Patients underwent initial PET in the first three months. They were divided into four groups according to the initial PET (high, high-average, lowaverage, low transport). Sociodemographic data, clinical courses and infectious complications between groups were compared, and the reasons for PD withdrawal were obtained. Technique survival analyses of patients were done. Results. In a total of 367 pts were PD was started, 104 pts were excluded. Data of the remaining 263 patients were evaluated. Thirty-seven pts (23F, mean age 44.6±16.5 years, mean follow-up 30.5±20.8 months) had high transport, 90 pts (49F, mean age 41.5±16 years, mean followup 42.6±27.7 months) had high-average transport, 91 pts (55F, mean age 44.5±14.9 years, mean follow-up 50±29.2 months) had low-average transport and 45 pts (17F, mean age 43.5±14 years, mean follow-up (63.4±34.5 months) had low transport. There was no difference between groups in terms of age, gender, body mass index, initial daily urine and ultrafiltration volume, initial albumin levels, presence of diabetes mellitus (p>0.05). Peritonitis and catheter exit-site/tunnel infection attacks were higher in patients with high transport (p=0.01 and 0.008, respectively). There was a difference between groups with respect to the last status of patients (p< 0.009). The major causes of deaths were peritonitis and/or sepsis and cardiovascular causes in all patients. The mortality and technique survival rate was found higher in patients with high transport (log rank: 0.004 and 0.027, respectively). Age (OR:1.045, p<0.001), initial albumin (OR: 0.482, p= 0.007), daily urine volume (OR: 1.045, p<0.001) and presence of catheter exit-site/tunnel infection (OR: 0.249, p<0.001) were found to predict patient survival. Only presence of catheter exit-site/tunnel infection (OR: 0.452, p=0.013) were found to predict patient survival. Conclusions. Initial PET has effects on PD patient survival; patients with high transport have the worst survival and frequent infectious complications.