A 10 YEAR ANZDATA ANALYSIS OF PERITONEAL DIALYSIS TECHNIQUE SURVIVAL
Dr Jarrad Hopkins1,2,3, Ms Annie Conway2,3, Professor Stephen McDonald1,2,3
1Central And Northern Adelaide Renal And Transplantation Services (cnarts), Adelaide, Australia, 2ANZDATA Registry, South Australia Health and Medical Research Institute, Adelaide, Australia, 3Faculty of Health and Medical Sciences, The University of Adelaide, Australia
Aim: To investigate the trends in Peritoneal Dialysis (PD) in Australia and New Zealand over a ten year period and assess the factors affecting technique survival.
Background: Peritoneal dialysis is the most abundant home based Kidney Replacement Therapy (KRT) with clear benefits for the patients and the health system. The proportion of people performing PD appears to be decreasing over time. Understanding technique survival changes overtime is critical towards understanding this.
Methods: Study Design: Registry based cohort study using Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. Inclusion criteria: All Australian PD patients older than 18, starting PD within 90 days of KRT entry from 2013 through 2022.
Analysis: Time to technique failure is modelled with a competing-risks regression, with death treated as competing risks. Covariates assessed included: Year starting PD, Age, Diabetes, Vascular Disease, Gender, Ethnicity and Whether or Not PD was first treatment at KRT.
Results: This study demonstrated a Hazard Ratio (HR) 1.03 (95% CI 1.01 – 1.04) (p<0.001) for technique failure increasing over time for this ten-year period. Infective technique failure HR 1.00 (95% CI 0.98-1.02) and non-infective technique failure HR 0.98 (95% CI 0.97 – 1.00). Diabetes and vascular disease had a HR 1.13 (1.05 – 1.21) and HR 1.12 (1.04-1.20) respectively. PD as a first mode of KRT was protective HR 0.69 (0.63 – 0.76).
Conclusion: Despite improvement in some areas of peritoneal dialysis (such as peritonitis rates), technique survival has been worsening over time. Further research and advocacy is required to understand and address this.
Biography:
Jarrad is currently a Nephrology Advanced Trainee at The Central and Northern Renal and Transplantation Service (CNARTS). He has a keen interest in chronic disease management, in particularly, dialysis and improving outcomes for all patients.