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Early technique failure in peritoneal dialysis patients in a multi-ethnic Asian country

  • Nephrology - Original Paper
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Abstract

Purpose

Early technique failure is a serious complication for peritoneal dialysis (PD) patients. The study aimed to examine the incidence, causes, and risk factors associated with early technique failure.  

Methods

This retrospective study included all incident PD patients in a hospital in Singapore from 2013 to 2017. The primary outcome was early technique failure, which was defined as transfer to hemodialysis for ≥ 30 days or death, within the first year of PD initiation. Secondary outcomes were death, technique failure due to PD infection, and death-censored technique failure.

Results

Overall, 517 patients were included in the study. Of these, 98 patients (19.0%) developed early technique failure. The common causes of early technique failure were death (41.8%) and infection (40.8%). Peripheral vascular disease was significantly associated with a higher hazard of early technique failure [hazard ratio (HR) 1.95, 95% confidence interval (CI) 1.04–3.63] and death (HR 3.75, 95% CI 1.71–8.21), whilst glomerulonephritis as a cause of end-stage kidney disease (compared with hypertension) was associated with a lower hazard of early technique failure (HR 0.38, 95% CI 0.18–0.77) and death (HR 0.08, 95% CI 0.02–0.37). Male gender was associated with early technique failure due to PD infection (HR 2.55, 95% CI 1.32–4.95). No specific factor was associated with death-censored early technique failure.

Conclusion

Technique failure in the first year of PD initiation occurs in one-fifth of PD patients and is associated with peripheral vascular disease and cause of end-stage kidney disease.

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Acknowledgements

The authors gratefully acknowledge the contributions of physicians and nurses from peritoneal dialysis unit, Singapore General Hospital.

Funding

No funding support for this study.

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Authors and Affiliations

  1. Department of Renal Medicine, Academia, Singapore General Hospital, Level 3, 20 College Road, Singapore, 169856, Singapore

    Riece Koniman, Marjorie Wai Yin Foo, Sin Yan Wu, Mathini Jayaballa, Chee Chin Phang, Elizabeth Ley Oei & Htay Htay

  2. Princess Alexandra Hospital, Brisbane, Australia

    David W. Johnson

  3. Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia

    David W. Johnson

  4. Translational Research Institute, Brisbane, Australia

    David W. Johnson

  5. Metro South and Ipswich Nephrology and Transplant Services (MINTS), Brisbane, Australia

    David W. Johnson

  6. Singapore Health Services, Health Services Research Centre (HSRC), Singapore, Singapore

    Ying Hao

Authors
  1. Riece Koniman
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  2. Marjorie Wai Yin Foo
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  3. David W. Johnson
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  4. Sin Yan Wu
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  5. Ying Hao
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  6. Mathini Jayaballa
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  7. Chee Chin Phang
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  8. Elizabeth Ley Oei
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  9. Htay Htay
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Corresponding author

Correspondence to Htay Htay.

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Conflicts of interest

Marjorie WY Foo has received consultancy fees and travel sponsorships from AWAK Technologies Pte Ltd, travel sponsorships from Baxter Healthcare, and grants from National Medical Research Council. David Johnson has received consultancy fees, research grants, speaker’s honoraria, and travel sponsorships from Baxter Healthcare and Fresenius Medical Care, consultancy fees from Astra Zeneca and AWAK, speaker’s honoraria and travel sponsorships from ONO, and travel sponsorships from Amgen. Htay Htay has received research grant from Johnson and Johnson Pte Ltd, and SingHealth Pte Ltd, and consultancy fees and travel sponsorships from AWAK Technologies Pte Ltd. She has also received speaker’s honoraria and travel sponsorships from Baxter Healthcare. The other authors have no financial conflicts of interest to declare.

Ethics approval

Centralised Institutional Review Board (CIRB) was consulted for approval. The study was granted exemption by CIRB given that the study was retrospective non interventional study and only de-identified data were used. (CIRB ref number: 201809-00057).

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The consent was waived as only de-identified data were used.

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The consent was waived as only de-identified data were used.

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Koniman, R., Foo, M.W.Y., Johnson, D.W. et al. Early technique failure in peritoneal dialysis patients in a multi-ethnic Asian country. Int Urol Nephrol 52, 1987–1994 (2020). https://doi.org/10.1007/s11255-020-02570-3

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  • DOI: https://doi.org/10.1007/s11255-020-02570-3

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