| Abstract |
Abstract
Objectives
The main purpose was to demonstrate the probability of risk of death linked to differing regimens of hypertonic peritoneal dialysis (PD) solution used.
Methods
A retrospective cohort study of patients using home-based PD was carried out. A regimen course of prescribed glucose-based PD solution used on the basis of individual conditions was extracted from the medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used; Original PD, Shuffle PD, and serialized PD. The multivariate analysis (Weibull model) was applied to comprehensively examine survival probabilities related to the explaining variable while adjusting for other potential confounders.
Results
Of a total of 300 consecutive patients, 38% died over a median follow-up time of 37 months (IQR: 25-51). Multivariate analysis showed that the treatment regimen with continued higher strength PD solution (Serialized PD) resulted in a lower survival rate than when the conventional strength solution was used ( HRadj, 2.6; 95% CI, 1.6-4.2, p <.001). The interrelationship of 5 (Age, length of time on PD, Hb, Alb, and oliguric urine) risk factors were significant predictors contributing to the outcome.
Conclusions
Frequent exposure to high levels of glucose PD solution is a factor contributing markedly to a two-fold lower survival, especially when hypertonic glucose is prescribed continuously. |
Publication
Journal Publication
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