Patient characteristics and risk factors of early and late death in incident peritoneal dialysis patients.

Xueqing Yu,Xiao Yang,Haishan Wu,Juan Wu,Rong Huang,Juan Wang,Xinhui Liu

doi:10.1038/srep32359

Abstract

This study was conducted to identify key patient characteristics and risk factors for peritoneal dialysis (PD) mortality in terms of different time-point of death occurrence. The incident PD patients from January 1, 2006 to December 31, 2013 in our PD center were recruited and followed up until December 31, 2015. Patients who died in the early period (the first 3 months) were older, had higher neutrophil to lymphocyte ratio (N/L), serum phosphorus, and uric acid level, and had lower diastolic pressure, hemoglobin, serum albumin, and calcium levels. After adjustment of gender, age, and PD inception, higher N/L level [hazard ratio (HR) 1.115, P = 0.006], higher phosphorus lever (HR 1.391, P < 0.001), lower hemoglobin level (HR 0.596, P < 0.001), and lower serum albumin level (HR 0.382, P = 0.017) were risk factors for early mortality. While, presence of diabetes (HR 1.627, P = 0.001), presence of cardiovascular disease (HR 1.847, P < 0.001) and lower serum albumin level (HR 0.720, P = 0.023) were risk factors for late mortality (over 24 months). In conclusion, patient characteristics and risk factors associated with early and late mortality in incident PD patients were different, which indicated specific management according to patient characteristics at the initiation of PD should be established to improve PD patient survival.

Highlights

The management of the Peritoneal dialysis (PD) patients was implemented based on the guidelines and recommendations from the International Society for Peritoneal Dialysis[8]
We identified patient characteristics and risk factors of mortality in PD patients who died at different periods of treatment
We found that patient characteristics, primary cause of end-stage renal disease, and cause of death were quite distinct among PD patients died within different periods of follow-up, and the risk factor pattern altered with PD duration

Summary

Introduction

Patients who died during 3 to 24 months were more likely to be diabetic and have cardiovascular disease, had lower 24 h urine output, intact parathyroid hormone (iPTH), and uric acid levels, compared with patients who survived the first 24 months (Table 2). Patients who died in the early period were older, had higher N/L, serum phosphorus, iPTH, and uric acid level, and had lower diastolic pressure, mGFR, hemoglobin, serum albumin, and calcium levels (see Supplemental Table S1).

Results

Conclusion