The Effect of Cigarette Smoking and Previous Hypertension on the Survival of Patients Treated by Continuous Ambulatory Peritoneal Dialysis

1985 ◽  
Vol 5 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Peter J. T. Drew ◽  
John Cunningham Stephen ◽  
J. W. Evans ◽  
Frank P. Marsh ◽  
Frank J. Goodwin
Keyword(s):  
Peritoneal Dialysis ◽  
Cigarette Smoking ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Severe Hypertension ◽  
Survival Rates ◽  
Technique Survival ◽  
London Hospital ◽  
History Of ◽  
Independent Effects

Life-table survival curves, computed for 107 patients undergoing CAPD at The London Hospital between July 1979 and March 1983, showed that patient survival at two years was 68% and overall treatment survival was 46%. However, when we excluded satisfactory outcomes of CAPD treatment, such as renal transplantation, as causes of treatment failure, the technique survival at two years was 62.5%. Age, cigarette smoking, and a history of severe hypertension had statistically significant and independent effects on survival and most deaths were due to causes not directly related to CAPD. Although the literature contains several reports on survival rates in patients on continuous ambulatory peritoneal dialysis (CAPD) (I, 2), we know little about the factors which influence the success of this treatment. We therefore performed an actuarial analysis of patient and treatment survival in 107 patients who started CAPD at The London Hospital between July 1979 and March 1983 and examined the effects of age, sex, cigarette smoking and previous hypertension -factors known to affect survival in the general population.

scholarly journals Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

2019 ◽  
Vol 28 (4) ◽  
pp. 329-37 ◽  
Author(s):  
Cahyani Gita Ambarsari ◽  
Partini Pudjiastuti Trihono ◽  
Agustina Kadaristiana ◽  
Taralan Tambunan ◽  
Lily Mushahar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Survival Rates ◽  
Published Data ◽  
Hospital Data ◽  
Technique Survival ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Stage Renal Disease

BACKGROUND The pediatric peritoneal dialysis (PD) program in Cipto Mangunkusumo Hospital, Indonesia was started in 2014. However, there has been no published data on the patients’ outcome. This study was aimed to report the characteristics and outcomes of a continuous ambulatory peritoneal dialysis (CAPD) program for children. METHODS This retrospective study was conducted in Cipto Mangunkusumo Hospital as a national referral hospital. Data were collected from medical records of patients aged ≤18 years with end-stage renal disease who underwent CAPD in 2014–2019. The baseline characteristics, PD-related infection rate, as well as patient and technique survivals were analyzed. RESULTS Out of 60 patients who underwent CAPD, 36 (60%) were boys on the age range of 4 months–18 years. The mean follow-up duration was 12 (95% confidence interval [CI] = 9.4–15.3) months. The number of PD related infections increased along with the growing number of patients on CAPD. The peritonitis rate was 0.42 episodes per year at risk, and the most common etiology was alpha-hemolytic Streptococcus (5/24, [20.8%]). The 1- and 3-year technique survival rates were 60.3% (95% CI = 44.5–72.9) and 43.9% (95% CI = 23.2–62.9). The 1- and 3-year patient survival rates were 69.6% (95% CI = 52.5–81.5) and 58% (95% CI = 31.2–77.5). CONCLUSIONS In this unit, CAPD could be performed in children as young as 4 months of age. The peritonitis rate was relatively low which was likely caused by skin-derived microorganisms. Both technique survival and patient survival were also relatively low.

MO704THE PROGNOSTIC IMPACT OF WEIGHT GAIN AFTER PERITONEAL DIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Win Hlaing Than ◽  
Jack K C Ng ◽  
Gordon C K Chan ◽  
Winston Fung ◽  
Cheuk Chun Szeto
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Peritoneal Dialysis ◽  
Weight Gain ◽  
Clinical Outcomes ◽  
Patient Survival ◽  
Survival Rates ◽  
Overweight And Obesity ◽  
Technique Survival ◽  
Technique Failure

Abstract Background and Aims The prevalence of obesity has increased over the past decade in patients with End Stage Kidney Disease (ESKD). Obesity at the initiation of peritoneal dialysis (PD) was reported to adversely affect clinical outcomes. However, there are few studies on the prognostic relevance of weight gain after PD. Method We reviewed the change in body weight of 954 consecutive PD patients from the initiation of dialysis to 2 years after they remained on PD. Clinical outcomes including patient survival, technique survival, and peritonitis rate in the subsequent two years were reviewed. Results The mean age was 60.3 ± 12.2 years; 535 patients (56.1%) were men and 504 (52.8%) had diabetes. After the first 2 years on PD, the average change in body weight was 1.2± 5.1 kg; their body weight was 63.0 ± 13.3 kg; body mass index (BMI) 24.4 ± 4.4 kg/m2. The patient survival rates in the subsequent two years were 64.9%, 75.0%, and 78.9% (log rank test, p = 0.008) for patients with weight loss ≥3 kg during the first 2 years of PD weight change between -3 and +3 kg, and weight gain ≥3 kg, respectively. The corresponding technique survival rates in the subsequent two years were 93.1%, 90.1%, 91.3%, respectively (p = 0.110), and the peritonitis rates were 0.7±1.5, 0.6±1.7, and 0.6±1.1 episodes per patient-year, respectively (p = 0.3). When the actual BMI after the first 2 years of PD was categorized into underweight, normal weight, marginal overweight, overweight, and obesity groups, the patient survival rates in the subsequent two years were 77.3%, 75.2%, 73.3%, 74.3%, and 75.9%, respectively (p= 0.005), and technique survival 98.0%, 91.9%, 88.0%, 92.8%, and 81.0%, respectively (p= 0.001). After adjusting for confounding clinical factors by multivariate Cox regression models, weight gain ≥ 3kg during the first 2 years of PD was an independent protective factor for technique failure (adjusted hazard ratio [AHR] 0.049; 95% confidence interval [CI] 0.004-0.554, p = 0.015), but was an adverse predictor of patient survival (AHR 2.338, 95%CI 1.149-4.757, p = 0.019). In contrast, weight loss ≥ 3kg during the first 2 years of PD did not predict subsequent patient or technique survival. Conclusion Weight gain during the first 2 years of PD confers a significant risk of subsequent mortality but appears to be associated with a lower risk of technique failure. The mechanism of this discordant risk prediction deserves further study.

Seven-Year Follow-Up of Peritoneal Dialysis Patients in Taiwan

2009 ◽  
Vol 29 (4) ◽  
pp. 450-457 ◽  
Author(s):  
Chih-Chung Shiao ◽  
Tze-Wah Kao ◽  
Kuan-Yu Hung ◽  
Yin-Cheng Chen ◽  
Ming-Shiou Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Peritoneal Dialysis ◽  
Survival Rate ◽  
Serum Albumin Level ◽  
Patient Survival ◽  
Survival Rates ◽  
Albumin Level ◽  
Technique Survival ◽  
Technique Failure

Background There are no Taiwanese publications and only a few Asian publications on the long-term outcome of peritoneal dialysis (PD) patients. The aim of this study was to evaluate the outcome of PD patients in Taiwan during a 7-year follow-up period. Patients and Methods This study enrolled 67 patients (23 males, mean age 46.2 ± 14.5 years) on maintenance PD. We administered the Short-Form questionnaire on 30 September 1998 and recorded major events and outcomes until 30 September 2005. We compared differences in initial parameters between groups categorized by PD patient survival and PD technique survival. Causes of mortality and transfer to hemodialysis were determined. PD patient and PD technique survival rates were measured and risk factors for patient mortality and PD technique failure were analyzed. Results Those in patient survival or PD technique survival groups had lower mean age ( p < 0.001 and 0.018 respectively) and higher serum albumin level ( p = 0.015 and 0.041 respectively) compared to those that died or failed PD. The 7-year patient survival rate was 77% and the PD technique survival rate was 58%. The independent predictors for PD technique failure included lower Mental Component Summary scores [hazard ratio (HR) = 0.85, p = 0.031] and diabetes mellitus (HR = 4.63, p < 0.001), whereas lower serum albumin level (HR = 0.22, p = 0.031), lower Physical Component Summary scores (HR = 0.67, p = 0.047), and presence of diabetes mellitus (HR = 5.123, p = 0.009) were the independent predictors for patient mortality. Conclusion For our PD patients, both patient and technique survival rates are good. Better glycemic control, adequate nutrition, and enhancement of health-related quality of life are all of potential prognostic benefit.

Survival Analysis and Associated Factors in THAI Patients on Peritoneal Dialysis under the PD-First Policy

2018 ◽  
Vol 38 (3) ◽  
pp. 172-178 ◽  
Author(s):  
Siribha Changsirikulchai ◽  
Suwannee Sriprach ◽  
Nintita Sripaiboonkij Thokanit ◽  
Jirayut Janma ◽  
Piyatida Chuengsaman ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Associated Factors ◽  
Patient Survival ◽  
Survival Rates ◽  
Female Gender ◽  
Health Coverage ◽  
Educational Levels ◽  
Technique Survival ◽  
Factors Associated ◽  
Stage Renal Disease

Background The peritoneal dialysis First (PD-First) policy means that PD is the first modality of dialysis chosen for patients with end-stage renal disease (ESRD), as put forth by the Universal Health Coverage (UHC) scheme. It was initiated in Thailand in 2008. Our aim is to analyze patient survival, technique survival, and associated factors. Methods Data of PD patients from January 2008 to November 2016 were studied. We calculated patient and technique survival rates (censored for death and kidney transplantation). Factors associated with survival were analyzed by the Cox proportional hazard model. Patient and technique survival rates between 2008 – 2012 and 2013 – 2016 were compared. Results Our study included 11,477 patients. The mean (standard deviation [SD]) age at initiation of PD was 54.0 (14.4) years. The level of education in 85.2% of cases was illiterate or primary school. A total of 60.9% of patients developed ESRD secondary to diabetes. The 1- to 5-year patient survival rates were 82.6, 71.8, 64.0, 58.5, and 54.0%, respectively. The first-year technique survival rate was 94.8%. The patient and technique survival rates during 2013 – 2016 were better than those seen during 2008 – 2012. Factors associated with lower patient survival rates were: female gender, increased age at start of PD, coverage with civil servant medical benefit scheme, low educational levels, and a history of diabetes. Conclusion Most patients had diabetes and low educational levels as seen in the outcomes in the previous literature. These factors impacted the survival of patients under the PD-First policy.

ASPD: A Prospective Study of Adequacy in Asian Patients on Long Term, Small Volume, Continuous Ambulatory Peritoneal Dialysis

2006 ◽  
Vol 26 (4) ◽  
pp. 466-474 ◽  
Author(s):  
Man Fai Lam ◽  
Colin Tang ◽  
Andrew K. Wong ◽  
Kwok Lung Tong ◽  
Alex W. Yu ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Peritoneal Dialysis ◽  
Body Mass ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Small Volume ◽  
Patient Survival ◽  
Survival Rates ◽  
Urine Volume ◽  
Asian Patients

Background The impact of small solute clearance on patient survival in continuous ambulatory peritoneal dialysis (CAPD) is not yet solidified. Previously, we demonstrated that CAPD using small volume (6 L) daily exchanges provides adequate dialysis for most Asian patients. Methods We conducted a prospective, long-term observational study to determine the optimal dialysis adequacy that may provide better patient survival for Asian patients who receive small-volume CAPD. We recruited 294 patients. The initial CAPD regime was 3 x 2-L exchanges daily. The same regime was maintained unless there was significant loss of ultrafiltration or fluid retention despite the use of hypertonic dialysate. Results Median study period was 38.9 (range 5 – 76.5) months, with 81% and 27% of patients remaining in the study at 24 and 48 months respectively. The overall survival rates at 2 and 4 years were 94.0% and 74.8% respectively. Our long-term data revealed that survival rate was related to Kt/V values. Survival rates were significantly higher for patients with total Kt/V > 2.0 than for patients with Kt/V < 1.7 ( p = 0.02). The former group had lower body mass index and higher residual renal function and peritoneal Kt/V than the latter group. On analysis using Cox proportional hazards regression models, cardiovascular disease (CVD), lower urine volume, and higher body mass index were independent predictors of mortality. Patients with higher renal Kt/V had a significantly lower risk of mortality (RR = 0.018, p = 0.01) after adjusting for the effects of CVD and diabetes mellitus. Conclusion Our data recommend that 1.7 be the minimal target for total Kt/V in patients on long-term CAPD. Patients with high body mass index, low residual urine volume, and significant CVD need close monitoring.

scholarly journals Clinical Outcome in Elderly Patients on Chronic Peritoneal Dialysis: A Retrospective Study from a Single Center in China

2014 ◽  
Vol 34 (3) ◽  
pp. 299-307 ◽  
Author(s):  
Upendra Joshi ◽  
Qunying Guo ◽  
Chunyan Yi ◽  
Rong Huang ◽  
Zhijian Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Serum Albumin ◽  
Patient Survival ◽  
Survival Rates ◽  
The Elderly ◽  
Elderly Group ◽  
Chronic Peritoneal Dialysis ◽  
Lower Serum ◽  
Technique Survival

ObjectivesWe aimed to evaluate clinical outcomes and identify the predictors of mortality in elderly patients undergoing continuous ambulatory peritoneal dialysis (CAPD).MethodsThis retrospective cohort study included all incident CAPD patients treated at our center from 2006 to 2009. Demographic and clinical data on initiation of CAPD and clinical events during the study period were collected. Survival probabilities were generated using the Kaplan–Meier method, and risk factors for mortality were evaluated using Cox proportional hazards models.ResultsOf 805 patients on CAPD, the elderly group (≥65 years; mean age: 71.3 ± 4.3 years) consisted of 148 patients, and the younger group (<65 years; mean age: 43.1 ± 12.2years) consisted of 657 patients. The 1-, 2-, 3-, and 5-year patient survival rates were 97%, 92%, 88%, and 73% for the younger group, and 79%, 67%, 56%, and 30% for elderly group. The patient survival rates were significantly lower for the elderly group than for the younger group ( p = 0.000). However, technique survival did not significantly differ between the groups ( p = 0.559). In the patients overall, the independent predictors of death were old age ( p = 0.003), diabetes ( p = 0.000), cardiovascular disease ( p = 0.006), lower hemoglobin ( p = 0.010), and lower serum albumin ( p = 0.024). Mortality in the elderly patients was associated with advanced age [relative risk (RR): 1.088; 95% confidence interval (CI): 1.027 to 1.153; p = 0.004], diabetes (RR: 2.064; 95% CI: 1.236 to 3.445; p = 0.006), and lower serum albumin (RR: 0.940; 95% CI: 0.897 to 0.985; p = 0.010).ConclusionsThe elderly patients on CAPD experienced technique survival comparable with that of younger patients, but their patient survival was lower. In elderly patients, mortality was determined predominantly by greater age, diabetes, and lower serum albumin. Our results indicate that chronic peritoneal dialysis is a viable dialysis option for elderly patients with end-stage renal disease. Better management of hypoalbuminemia and comorbid conditions might improve survival in elderly PD patients.

scholarly journals Impact of Dialysis Adequacy on the Mortality and Morbidity of Anuric Chinese Patients Receiving Continuous Ambulatory Peritoneal Dialysis

2001 ◽  
Vol 12 (2) ◽  
pp. 355-360 ◽  
Author(s):  
CHEUK-CHUN SZETO ◽  
TERESA YUK-HWA WONG ◽  
KAI-MING CHOW ◽  
CHI-BON LEUNG ◽  
MAN-CHING LAW ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Residual Renal Function ◽  
The Body ◽  
Chinese Patients ◽  
Dialysis Adequacy ◽  
Technique Survival

Abstract. Dialysis adequacy has a major impact on the outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. However, most studies on peritoneal dialysis adequacy have focused on patients with significant residual renal function. The present study examined the effect of dialysis adequacy on anuric CAPD patients. A single-center prospective observational study on 140 anuric CAPD patients was performed. These patients were followed for 22.0 ± 11.9 mo. Dialysis adequacy and nutritional indices, including Kt/V, creatinine clearance (CCr), protein equivalent nitrogen appearance, percentage of lean body mass, and serum albumin level were monitored. Clinical outcomes included actuarial patient survival, technique survival, and duration of hospitalization. In the study population, 64 were male, 36 (25.7%) were diabetic, and 59 (42.1%) were treated with 6 L exchanges per day. The body weight was 59.2 ± 10.2 kg. Average Kt/V was 1.72 ± 0.31, and CCr was 43.7 ± 11.5 L/wk per 1.73m2. Two-yr patient survival was 68.8%, and technique survival was 61.4%. Multivariate analysis showed that DM, duration of dialysis before enrollment, serum albumin, and index of dialysis adequacy (Kt/V or CCr) were independent factors of both patient survival and technique survival. It was estimated that for two patients who differed only in weekly Kt/V, a 0.1 higher value was associated with a 6% decrease in the RR of death (P < 0.05; 95% confidence interval, 0.92 to 0.99). Serum albumin and CCr were the only independent factors that predicted hospitalization. It was found that even when there is no residual renal function, higher dialysis dosage is associated with better actuarial patient survival, better technique survival, and shorter hospitalization. Dialysis adequacy has a significant impact on the clinical outcome of CAPD patients, and the beneficial effect is preserved in anuric patients as well as in an ethnic group that has a low overall mortality.

Changes in Outcomes over Time among Incident Peritoneal Dialysis Patients in Southern China

2019 ◽  
Vol 39 (4) ◽  
pp. 382-389 ◽  
Author(s):  
Yuan Peng ◽  
Hongjian Ye ◽  
Chunyan Yi ◽  
Meiju Wu ◽  
Xuan Huang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Lower Risk ◽  
Patient Survival ◽  
Southern China ◽  
Survival Rates ◽  
Technique Survival ◽  
Gender And Age ◽  
All Cause Mortality ◽  
Estimate Glomerular Filtration Rate ◽  
Male Patients

BackgroundThe present study was to investigate the changes in outcomes of incident patients who started peritoneal dialysis (PD) between 2006 – 2010 and 2011 – 2015 in Southern China.MethodsIn this single-center cohort study, incident PD patients from January 1, 2006, to December 31, 2015, were enrolled. Collected data included baseline demographic, clinical, biochemical characteristics, and outcomes. Patients who initiated PD during 2006 – 2010 and 2011 – 2015 were followed up until December 31, 2011, and December 31, 2016, respectively. Peritonitis rate, patient survival, and technique survival were compared between the 2 incident cohorts.ResultsA total of 2,021 incident PD patients were enrolled, with a mean age of 47.2 ± 15.2 years, 40.6% female. Compared with the 2006 – 2010 cohort ( n = 1,073), patients initiating PD during 2011 – 2015 ( n = 948) were younger (46.2 ± 14.8 vs 48.1 ± 15.5 years, p = 0.006), had similar baseline estimate glomerular filtration rate (eGFR) (5.81 ± 2.41 vs 5.81 ± 2.89 mL/ min/1.73 m2, p = 0.109) and comparable percentage of diabetes mellitus (24.9% vs 25.7%, p = 0.682). The overall peritonitis rate in the 2011 – 2015 cohort was lower than in the 2006 – 2010 cohort (0.158 vs 0.161 episodes per year, p = 0.001). At the end of 1, 3, and 5 years, the 2006 – 2010 and 2011 – 2015 cohorts had patient survival rates of 94%, 82%, 64%, and 97%, 87%, 74%, respectively ( p < 0.001). After multivariable adjustment, patients starting PD in 2011 – 2015 were associated with lower risk of all-cause mortality (hazard ratio [HR] 0.77, 95% confidence interval [CI] 0.60 – 0.98). In gender and age-stratified models, male patients had a significantly lower risk of all-cause mortality (HR 0.58, 95% CI 0.41 – 0.83), and patients with age < 65 years showed a significantly lower risk of cardiovascular (CV) mortality (HR 0.63, 95% CI 0.40 – 0.99) in 2011 – 2015 compared with 2006 – 2010. The death-censored technique survival rates were not significantly different between the 2 cohorts ( p = 0.234).ConclusionPeritonitis rates and patient survival on PD continue to improve. Patients initiating PD between 2011 and 2015 were associated with better outcomes.

Good Patient and Technique Survival in Elderly Patients on Continuous Ambulatory Peritoneal Dialysis

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 196-201 ◽  
Author(s):  
Philip Kam-Tao Li ◽  
Man Ching Law ◽  
Kai Ming Chow ◽  
Chi-Bon Leung ◽  
Bonnie Ching-Ha Kwan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Self Care ◽  
The Elderly ◽  
Elderly Group ◽  
Control Group ◽  
Technique Survival ◽  
Esrd Patients

The aging population has significant implications for the community. The increasing number of elderly end-stage renal disease (ESRD) patients presses the renal team to find an appropriate management plan. We used a retrospective analysis to study the effectiveness of continuous ambulatory peritoneal dialysis (CAPD) in elderly ESRD patients. Of the 328 CAPD patients recruited for the study, 121 were in the elderly group (≥ 65 years of age), and 207 were in the control group (under 65 years of age). Median age in the elderly group was 71 years, and in the control group, 51 years. The elderly group had a higher prevalence (54.5%) of diabetes mellitus. The 2-year and 5-year rates of patient survival were 89.3% and 54.8% respectively in the elderly group and 92.2% and 62.9% in the control group ( p = 0.19). The 2-year and 5-year rates of technique survival were 84.0% and 45.7% respectively in the elderly group and 80.9% and 49.1% in the control group ( p = 0.75). The probability of a 12-month peritonitis-free period was 76.6% in the elderly group and 76.5% in the control group ( p = 0.75). One hundred elderly patients (82.6% of the group) performed their CAPD exchanges by themselves. We observed no significant difference in clinical outcome—including patient survival, technique survival, and peritonitis-free period—between the elderly self-care CAPD and the elderly assisted CAPD groups. In elderly ESRD patients, CAPD is an effective dialysis modality. A slightly longer training time is to be expected for elderly patients. Self-care CAPD for elderly patients who are capable of performing their own exchanges provides them with an independent home life.

Independent Effects of Renal and Peritoneal Clearances on the Mortality of Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Teresa Yuk-Hwa Wong ◽  
Kai-Ming Chow ◽  
Chi-Bon Leung ◽  
Man-Ching Law ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Patient Survival ◽  
Residual Renal Function ◽  
University Teaching ◽  
Dialysis Adequacy ◽  
Protein Nitrogen ◽  
Technique Survival ◽  
Independent Effects

Objective Previous studies show that peritoneal Kt/V is an independent predictor of survival in anuric patients receiving continuous ambulatory peritoneal dialysis (CAPD). We studied whether peritoneal Kt/V has the same effect in CAPD patients with residual renal function. Design Observational cohort study. Setting Single dialysis center in a university teaching hospital. Patients New and prevalent CAPD patients. Methods We examined the 5-year follow-up results of our prospective study previously reported ( Kidney Int 2000; 58:400–7). A total of 270 CAPD patients were followed for up to 6 years. Dialysis adequacy indices, residual renal function, and nutritional data were monitored. Outcome Measures Primary outcomes included mortality and technique failure. Peritoneal Kt/V rather than total Kt/V was used for multivariate survival analysis. Results Average duration of follow-up was 35.1 ± 22.0 months. Average peritoneal Kt/V throughout the study was 1.59 ± 0.37; median residual glomerular filtration rate (GFR) 0.82 mL/minute. Five-year actuarial patient survival was 41.5%, and technique survival was 23.1%. Multivariate analysis showed that sex, age, duration of dialysis, presence of diabetes, serum albumin, dialysate-to-plasma creatinine ratio at 24 hours, peritoneal Kt/V, residual GFR, and normalized protein nitrogen appearance were independent factors of both actuarial patient survival and technique survival. For every 0.1 unit higher peritoneal Kt/V, relative mortality risk was 0.94 (95% CI 0.89 – 0.99, p = 0.03). When prevalent and new CAPD cases were analyzed separately, peritoneal Kt/V predicted survival only for prevalent CAPD patients. Conclusion We conclude that, in prevalent CAPD patients with relatively low levels of peritoneal clearance and residual renal function, a higher peritoneal Kt/V is associated with better survival. Peritoneal clearance below 1.6 – 1.7 likely has a major detrimental effect on the clinical outcome of CAPD patients with little residual renal function.

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