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Long-term clinical outcomes of peritoneal dialysis patients: single center experience from Korea

Authors
 Seung Hyeok Han  ;  Jung Eun Lee  ;  Dong Ki Kim  ;  Sung Jin Moon  ;  Hyun-Wook Kim  ;  Jae Hyun Chang  ;  Beom Seok Kim  ;  Shin-Wook Kang  ;  Kyu Hun Choi  ;  Ho Yung Lee  ;  Dae Suk Han 
Citation
 Peritoneal Dialysis International, Vol.28(suppl 3) : 21-26, 2008 
Journal Title
 Peritoneal Dialysis International 
ISSN
 0896-8608 
Issue Date
2008
Abstract
Of a large body of literature reporting clinical outcomes for patients maintained on peritoneal dialysis (PD), most publications have focused on relatively short-term results. Few reports have focused on long-term survival in PD patients. Here, we present our experience with long-term patient outcomes and further analyses of the trends in demographics and clinical outcomes of 2301 end-stage renal disease (ESRD) patients treated with continuous ambulatory PD (CAPD) during a 25-year period (1981 - 2005) at our institute. Outcomes were analyzed for 1656 patients, excluding those younger than 15 years of age at initiation of CAPD, those having less than 3 months' follow-up, or those who had been on hemodialysis or who received a kidney graft before starting CAPD. In the study patients, technique survival at 5 and 10 years was 71.9% and 48.1% respectively. Patient survival was 69.8% and 51.8%. Mean age at the start of PD (50.4 +/- 13.9 years vs. 44.2 +/- 13.9 years, p < 0.01), ESRD incidence as a result of diabetic nephropathy (30.5% vs. 19.5%, p < 0.01), and incidence of cardiovascular comorbidities (26.6% vs. 20.5%, p < 0.01) were all significantly greater in patients who started PD during the second half of the study period (1993 - 2005) as compared with the first half (1981 - 1992). A multivariate analysis adjusting for these changes in demographics and comorbid conditions revealed that PD therapy starting in 1993 - 2005 was associated with a significant reduction in technique failure [hazard ratio (HR): 0.65; p < 0.01] and mortality (HR: 0.68; p < 0.01) as compared with the earlier period. However, in subgroup analyses, technique survival was not observed to be significantly improved in patients with diabetes. In summary, technique and patient survival have significantly improved despite increases in patient age, cardiovascular comorbidity, and ESRD caused by diabetes. Although diabetes, older age, and cardiovascular comorbidities are not factors that are easily modifiable to improve PD outcomes, results at our institution are encouraging in an era of declining PD utilization.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
김동기(Kim, Dong Ki)
김범석(Kim, Beom Seok) ORCID logo https://orcid.org/0000-0002-5732-2583
김현욱(Kim, Hyun Wook) ORCID logo https://orcid.org/0000-0002-4274-7562
문성진(Moon, Sung Jin)
이정은(Lee, Jung Eun) ORCID logo https://orcid.org/0000-0003-0917-2872
이호영(Lee, Ho Yung)
장제현(Chang, Jae Hyun)
최규헌(Choi, Kyu Hun) ORCID logo https://orcid.org/0000-0003-0095-9011
한대석(Han, Dae Suk)
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106672
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