Comparison of All-cause Mortality and Technique Failure Between Early-late and Very Late Start Peritoneal Dialysis: A Retrospective Cohort Study

Authors

  • Nathaphop Chaichaya1 , Bandit Thinkhamrop2 , Sajja Tatiyanupanwong3 , Katharine Morley4 , Michael Morley5 , Wilaiphorn Thinkhamrop6 , Wongsa Laohasiriwong7

DOI:

https://doi.org/10.37506/mlu.v20i4.2097

Keywords:

End-stage renal disease, end-stage kidney disease, delayed PD, formula, equation.

Abstract

Background: Glomerular filtration rate (GFR) is the gold standard for the detection and monitoring of
chronic kidney disease (CKD). Controversy is remaining in the timing of peritoneal dialysis (PD).
Objective: This study compared all-cause mortality and technique failure between early-late and very late
start PD in stage-5 CKD patients.
Method: A cohort of 828 stage-5 CKD patients from a tertiary hospital was reviewed and analyzed. Patients
were categorized into groups of early-late or very late start PD according to their estimated-GFRs. The
outcomes were all-cause mortality and technique failure. Survival analysis was performed.
Results: Median time to all-cause mortality was 35 months in early-late group, 40 months in very late
group, while technique failure was found identical in both groups (25 months). There were no statistically
significant association in cox regression models.
Conclusion: No clinical benefits were found by starting dialysis based on eGFR at the timing of PD (early
or very late start PD plan). Asymptomatic patients with stage-5 CKD may be safely managed by very late
start PD plan and patients may benefit from the delayed PD initiation.

Author Biography

  • Nathaphop Chaichaya1 , Bandit Thinkhamrop2 , Sajja Tatiyanupanwong3 , Katharine Morley4 , Michael Morley5 , Wilaiphorn Thinkhamrop6 , Wongsa Laohasiriwong7

    1
    Doctor of Philosophy in Epidemiology and Biostatistics (International Program), Faculty of Public Health,
    KhonKaen University, Thailand, 2
    Associate Professor, Department of Biostatistics and Demography, Faculty of
    Public Health, KhonKaen University, Thailand, 3Nephrologist, Kidney Unit, Department of Internal Medicine,
    Chaiyaphum Hospital, Chaiyaphum, Thailand, 4 Internal Medicine Specialist, Department of Medicine,
    Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, 5Ophthalmologist,Department
    of Ophthalmology, Harvard Medical School, Boston, MA, USA, 6
    Statistician, Data Management and Statistical
    Analysis Center, Faculty of Public Health, KhonKaen University, Thailand, 7Associate Professor, Faculty of Public
    Health, KhonKaen University, Thailand

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Published

2020-11-18

Issue

Vol. 20 No. 4 (2020): Medico-Legal Update

Section

Articles

How to Cite

Comparison of All-cause Mortality and Technique Failure Between Early-late and Very Late Start Peritoneal Dialysis: A Retrospective Cohort Study. (2020). Medico Legal Update, 20(4), 1771-1778. https://doi.org/10.37506/mlu.v20i4.2097