Trend of peritoneal transport and impact on patient survival: A 10-year follow-up cohort study .

Abstract

Peritoneal transport has an impact on clinical outcomes, but it is not constant in peritoneal dialysis (PD) patients. Large-scale, longitudinal data in different types of transport patients are lacking. This study aimed to elucidate the changing trend of peritoneal transport and its impact on patient outcomes. All patients who entered the PD program in a local hospital in Hong Kong from 1995 to 2012 and underwent more than one peritoneal equilibration test (PET) were analyzed retrospectively, excluding those with peritonitis before the first PET. PET was performed yearly on a routine basis. Peritoneal transport was classified according to the dialysate-to-plasma creatinine ratio (D/P Cr). Survival rates of this cohort were analyzed for up to 10 years. A total of 470 patients fulfilled the study criteria, with a mean age of 63.2 ± 14.3 years and a 40% diabetes occurrence. Mean D/P Cr dropped significantly in the first year and remained constant thereafter. A slow, increasing trend was observed after year 5. In the first few years, D/P Cr declined significantly in the high and high-average transport patients and increased in the low-average and low transport patients. There was no significant difference in patient and technique survival rates according to baseline transport groups. D/P Cr only became a significant risk factor for mortality by year 3 onwards. A centripetal trend of change in peritoneal transport was observed in the first year. High peritoneal transport was associated with poorer patient outcomes only after the first few years of PD. The initial peritoneal transport status was not a determinant factor of patient survival in long-term PD. .