Peritoneal dialysis outcomes in patients with nephrotic syndrome: a propensity score-matched cohort study

Abstract

Introduction: It is unclear whether patients with end-stage renal disease (ESRD) and nephrotic syndrome (NS) can be treated with peritoneal dialysis (PD). Objectives: To investigate the outcomes of PD treatment in ESRD patients with or without NS. Methods: In this retrospective cohort study, all incident patients with ESRD and NS who started PD from 1 February 2006 to 31 December 2017, were matched with patients without NS using propensity scores based on age, sex, diabetes mellitus status, and serum albumin. Results: Fifty-three patients in the NS PD group and 53 matched controls were included. The median survival of the NS PD group was comparable to that of the non-NS PD group. An interaction effect was observed between survival time and baseline NS status. Thus, patients’ outcomes within and after 1.5 years were analyzed separately. Both mortality (log-rank test, p= .235) and technique failure (log-rank test, p= .543) rates within 1.5 years in patients with NS were comparable to those of the non-NS group. After 1.5 years, however, the NS status at baseline was associated with lower all-cause mortality (p= .020) and lower technique failure (p= .008) rates in PD patients compared with the non-NS group. The multivariable Cox regression analysis showed that compared with the patients in the non-NS PD group, PD patients with NS had both significantly lower all-cause mortality and lower technique failure rate after adjusting for other factors. Conclusions: Our study indicates that PD may be considered as a long-term renal replacement therapy for patients with ESRD and baseline NS.