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

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.

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Comparison of patient survival and technique survival between continuous ambulatory peritoneal dialysis and automated peritoneal dialysis

Peritoneal Dialysis International ◽

10.1177/0896860820942987 ◽

2020 ◽

Vol 40 (6) ◽

pp. 563-572

Author(s):

I-Kuan Wang ◽

Tung-Min Yu ◽

Tzung-Hai Yen ◽

Shih-Yi Lin ◽

Chia-Ling Chang ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Lower Risk ◽

Patient Survival ◽

Diabetic Patients ◽

Automated Peritoneal Dialysis ◽

Technique Survival ◽

Peritoneal Permeability ◽

Male Patients ◽

Technique Failure

Background: This retrospective cohort study compared patient survival and technique survival between patients on continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) using recent data at a single tertiary medical center in Taiwan. Methods: From medical records, we identified incident 459 CAPD patients and 266 APD patients on dialysis for at least 90 days and aged more than 18 years to estimate mortality and technique failure rates, and related hazard ratio (HR) and 95% confidence interval (CI) from 2007 to 2018. Results: There were more women (52.3%) in the CAPD group, whereas patients in the APD group were younger. Compared to CAPD patients, APD patients had a lower mortality rate (2.83 vs. 5.79 per 100 person-years) with an adjusted HR of 0.69 (95% CI = 0.47–1.02), and a lower technique failure rate (9.70 vs. 17.52 per 100 person-years) with an adjusted HR of 0.65 (95% CI = 0.51–0.83). Further subgroup analyses revealed that, compared to CAPD, APD was associated with a significant lower risk of technique failure in male patients, patients aged 50–65 years, diabetic patients, patients without cardiovascular disease (CVD), patients with higher peritoneal permeability, or patients initiating PD in an earlier era. Conclusions: The mortality risk was not significant between CAPD and APD patients. APD is associated with a lower risk of technique failure than CAPD, particularly for male patients, and patients aged 50–65 years, with diabetes, without CVD, with high or high average peritoneal permeability, or initiating PD in an earlier era.

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MO704THE PROGNOSTIC IMPACT OF WEIGHT GAIN AFTER PERITONEAL DIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab101.0026 ◽

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.

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Advancing the Use and Quality of Peritoneal Dialysis by Developing a Peritoneal Dialysis Satellite Center Program

Peritoneal Dialysis International ◽

10.3747/pdi.2010.00041 ◽

2011 ◽

Vol 31 (2) ◽

pp. 121-126 ◽

Cited By ~ 22

Author(s):

Zongpei Jiang ◽

Xueqing Yu

Keyword(s):

Peritoneal Dialysis ◽

Rural Areas ◽

Southern China ◽

Survival Rates ◽

Dropout Rate ◽

Full Time ◽

Technique Survival ◽

Treatment Practices ◽

Center Program

BackgroundPeritoneal dialysis (PD) is developing rapidly in China, but because there are not enough well-trained PD doctors and nurses in more rural areas, this expansion is occurring mainly in larger cities. To address this imbalance, our center established a PD satellite center program across Guangdong Province, with the aim of extending the use and improving the quality of PD.MethodsSun Yat-sen University PD center is responsible for running the satellite program. The PD satellite centers are selected using specific criteria. The full-time PD physicians and nurses in the satellite centers accept a unified training program and treatment practices, and their clinical outcomes are carefully followed by our center.ResultsThe program began in January 2008, and there are now 12 PD centers from which 26 doctors and 32 nurses received PD training. Several hundred patients are now receiving PD through this program. The total number of PD patients treated by our center and the satellites increased to 1860 from 1010. The number treated in the satellite units increased to 1165 from 601. The annual dropout rate fell to 17.6% from 28.2%, and the average peritonitis incidence fell from 1 episode in 39.4 patient–months to 1 episode in 46.2 patient–months. The 1-year patient and technique survival rates increased to 84.2% from 82.0% and to 93% from 88.7% respectively.ConclusionsOur PD satellite center program is a good model for increasing the use and improving the quality of PD in rural areas. We plan to expand this program to other parts of southern China.

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

Peritoneal Dialysis International ◽

10.1177/089686080902900412 ◽

2009 ◽

Vol 29 (4) ◽

pp. 450-457 ◽

Cited By ~ 10

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.

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

Medical Journal of Indonesia ◽

10.13181/mji.v28i4.3807 ◽

2019 ◽

Vol 28 (4) ◽

pp. 329-37 ◽

Cited By ~ 4

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.

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

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00127 ◽

2018 ◽

Vol 38 (3) ◽

pp. 172-178 ◽

Cited By ~ 5

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.

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Clinical Outcomes of Remote Peritoneal Dialysis Patients: A Retrospective Cohort Study from a Single Center in China

Blood Purification ◽

10.1159/000442516 ◽

2015 ◽

Vol 41 (1-3) ◽

pp. 100-107 ◽

Cited By ~ 6

Author(s):

Chunyan Yi ◽

Qunying Guo ◽

Jianxiong Lin ◽

Fengxian Huang ◽

Xueqing Yu ◽

...

Keyword(s):

Cohort Study ◽

Peritoneal Dialysis ◽

Clinical Outcomes ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Southern China ◽

Survival Rates ◽

Technique Survival ◽

Home Based

Background/Aims: To investigate clinical outcomes of remote peritoneal dialysis (PD) patients in Southern China. Methods: In this retrospective cohort study, incident remote PD patients managed with a comprehensive follow-up program in our PD center were included and clinical outcomes were estimated. Results: One thousand and five remote PD patients with mean age 46.1 ± 14.6 years, of which 38.1% were women, were followed-up for a median of 35.7 months. Patient survival rates were 95.4, 84.7 and 71.8% and death-censored technique survival rates were 98.6, 92.3 and 83.4% at 1, 3 and 5 years, respectively. Peritonitis rate was 0.16 episodes per patient-year. Advanced age, diabetes mellitus, shorter peritonitis-free survival time, poor compliance for regular visiting nephrologists and lower hemoglobin predicted all-cause mortality of remote PD patients. Conclusion: The remote PD patients in Southern China managed with comprehensive follow-up program had favorable clinical outcomes, which indicated that home-based PD therapy could be an appropriate treatment option for remote end-stage kidney disease patients.

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

Peritoneal Dialysis International ◽

10.3747/pdi.2012.00209 ◽

2014 ◽

Vol 34 (3) ◽

pp. 299-307 ◽

Cited By ~ 11

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.

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Correlations between gender, age and the risk of withdrawal from peritoneal dialysis

10.21203/rs.3.rs-25404/v1 ◽

2020 ◽

Author(s):

Min Yan Zhang ◽

Miao He ◽

Sheng Wan ◽

Qiong Yan Ding ◽

Lei Liu ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Renal Disease ◽

Serum Albumin ◽

End Stage Renal Disease ◽

Technique Survival ◽

Gender And Age ◽

Male Patients ◽

Stage Renal Disease ◽

End Stage ◽

The Impact

Abstract Background With the increasing incidence of end stage renal disease(ESRD),peritoneal dialysis(PD) has become the preferred method of kidney replacement therapy for an increasing number of patients with end stage renal disease due to its many advantages.The intent of this study was to explore the correlations between sex, age and risk of withdrawal from peritoneal dialysis.Methods All patients who underwent PD catheterization and initiated PD at Wuhan No.1 Hospital between 2013 and 2018 were screened.Clinical information of these patients was collected and compared according to gender and age,then was applied to the Cox proportional hazards model to determine the impact of factors of withdrawal from peritoneal dialysis.Results ①Hazard ratios(HRs) of withdrawal of PD associate with gender and age at initiation were 0.736(P = 0.289)、1.151༈P = 0.489༉respectively.Nonetheless,male patients under 60 years old had a 1.58-fold higher risk of withdrawal than others(HR 0.63,P = 0.031).②The withdrawal risk of patients with total Creatinine clearance rate (Ccr) above 60L/W was 82.4% higher than that of patients who did not meet the standard (HR 1.82,P = 0.005).③The withdrawal risk of patients with high D/P Creatinine༈Cr༉value which was calculated from peritoneal equilibration test(PET) were 2.06 times higher than low-average and high-average transport patients(HR2.06,P = 0.008).④Patients with serum albumin above 35 g/L were intended to withdraw from PD than those below 35 g/L (HR 0.56,P = 0.006).Conclusions There were significant differences in total KT/V, total Ccr,serum creatinine(Scr) and blood Urea nitrogen(BUN)among patients with PD of different gender and age.The analysis showed that male patients under 60 years old, Ccr, value of D/Pcr and serum albumin had a high correlation with the technical survival rates.While gender or age at PD initiation were not associated with technique survival,male patients under 60 years old had a 1.58-fold higher risk of withdrawal from PD than others.The outcome that the withdrawal risk of patients with Ccr above 60L/W was 82.4% higher than other patients who did not meet the standard suggested that Ccr was not suitable as an index for evaluating the adequacy of PD,especially for men under 60 years old.And patients with high D/Pcr value or with serum albumin under 35 g/L were related risk factors for technique survival.

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Ten-year survival of patients treated with peritoneal dialysis: A prospective observational cohort study

Peritoneal Dialysis International ◽

10.1177/0896860820927534 ◽

2020 ◽

Vol 40 (6) ◽

pp. 573-580

Author(s):

Xi Xia ◽

Yagui Qiu ◽

Jing Yu ◽

Tong Lin ◽

Miaoqing Lu ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Peritoneal Dialysis ◽

Clinical Characteristics ◽

Survival Rates ◽

Secondary Outcome ◽

Technique Survival ◽

Improved Outcomes ◽

All Cause Mortality ◽

Observational Cohort ◽

Technique Failure

Background: Few studies evaluated over 5-year outcomes of dialysis patients. This study examined 10-year all-cause mortality and death-censored technique failure in a cohort of incident peritoneal dialysis (PD) individuals. Methods: Five hundred and thirty-three incident PD individuals from 2006 to 2008 were prospectively followed up for more than 10 years until 2018. Clinical characteristics at PD initiation were collected. The primary outcome was all-cause mortality, and the secondary outcome was death-censored technique failure. Cox hazards models were fit using clinical characteristics at PD initiation. Results: The mean age starting PD for these participants was 48 ± 16 years; 130 (24%) patients had diabetic nephropathy. During follow-up, 208 patients died, and 84 patients experienced technique failures. The 1, 3, 5, and 10 years’ survival rates for incident PD patients were 93%, 81%, 64%, and 36%, respectively, and the technical survival rates were 98%, 93%, 85%, and 62%, respectively. Mortality risk was much higher after 3 years on PD. The peritonitis rate was 0.19 episodes per patient-year, and 7 (1.3%) patients had encapsulating peritoneal sclerosis (EPS) giving an incidence rate of 3.1 of 1000 patient-years. The main causes of death were cardiovascular events (97 of 208, 47%), and technique failure was mainly due to peritonitis (41 of 84, 49%). Older age, higher Charlson comorbidity index, and lower level of education were strongly associated with mortality, and diabetic nephropathy was an independent risk factor for technique failure. Conclusions: The 10-year’s survival and technique survival rates of incident PD patients were 36% and 62%. Long-term PD can be continued successfully with improved outcomes and low risk for EPS.

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