Patient outcome in primary peritoneal dialysis patients versus those transferred from hemodialysis and transplantation

Background According to the concept of integrated
care, renal transplantation, peritoneal dialysis (PD),
and hemodialysis (HD) should be considered three
complementary methods of renal replacement therapy.
This study tried to evaluate patient outcomes in three
different groups of PD patients, namely primary PD
patients, those transferred to PD with failing kidney
transplant, and those transferred to PD from HD.
Method From January 1, 1995, to end of 2006 from
26 PD centers, 1,355 patients including demographic,
clinical and laboratory data, which were monthly
collected through questionnaires, were enrolled in the
study. We compared patients’ characteristics, factors
affecting patient survival, and patient outcomes
between primary PD patients (group 1, n = 1,067),
patients transferred from transplantation (group 2,
n = 43) and those transferred from HD (group 3,
n = 245), which had been on HD for at least 3 months
before switching to PD.
Results There was no difference in the proportion of
patients with diabetes in the three groups. Overall, 238
patients (17.5%) were transferred to HD but there was
no significant difference in PD technique survival on
between the three groups. Death occurred in 256
(24%), 3 (7%) and 65 (26.5%) subjects in groups 1, 2
and 3, respectively. Most patients (81.5%) in group 2
underwent re-transplantation. The Kaplan–Meier survival
rates were not different between the three
groups. In the Cox multiple regression model, age,
presence of diabetes and serum albumin level significantly
influenced patient survival.
Conclusion We concluded that PD could be considered
safe for patients experiencing complications on
HD, as well as for those with renal transplantation