A RETROSPECTIVE REVIEW OF THE CLINICAL OUTCOMES OF PERITONEAL DIALYSIS FIRST AND PERITONEAL DIALYSIS SWITCH PATIENTS AT THE NATIONAL KIDNEY AND TRANSPLANT INSTITUTE

E-Poster

Abstract Title

First Name *

josie mae

Last Name *

jaranilla

Co-author 1

melo jane paz jaranilla.josiemae@yahoo.com national kidney and transplant institute adult nephrology quezon city

Co-author 2

hazel ninalga jaranilla.josiemae@yahoo.com national kidney and transplant institute adult nephrology quezon city

Co-author 3

Co-author 4

Co-author 5

Co-author 6

Co-author 7

Co-author 8

Co-author 9

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Co-author 15

Introduction

Peritoneal Dialysis is an effective renal replacement strategy for patients suffering from chronic kidney disease. The autonomy and the convenience that PD offers to patients in the comfort of their homes make PD first a reasonable and wise option in initiating dialysis. The treatment cost is likewise considerably cheaper.

PD first patients are those initiated on PD as their first dialysis modality. PD switch patients are those who initially started on hemodialysis and for whatever reason were shifted to PD as their dialysis modality. There are several reasons that lead patients to switch to PD after an initial period of facility-based hemodialysis. Most of these hemodialysis patients are shifted to PD due to financial reasons because they cannot sustain the cost of facility based hemodialysis. Likewise, PD is sometimes the last option because of multiple access failure.

Patients on PD switch showed a significantly higher probability of technique failure as compared to PD first group1. In terms of mortality, a higher incidence was noted among PD switch group than the PD first group2.

Methods

Chart review from the medical records section and NKTI computer database system were accessed for all adult service patients who underwent PD initiation whether PD first or PD switch during the study period. The following patients were excluded in this study: patients who were initially started on PD but eventually underwent kidney transplant, patients who were initiated with Peritoneal dialysis at NKTI but were lost to follow up during the study period, patients who initially underwent acute hemodialysis then shifted to peritoneal dialysis after they were stabilized, patients under the care of a private nephrologist and hemodialysis patients for more than 365 days prior to switch to peritoneal dialysis.

The following data were collected: demographic profile, number of hospital admissions, emergency room consults or CAPD clinic consults due to PD related problems whether infectious or mechanical, causes of PD catheter malfunction and for PD switch patients, the cause of transfer to peritoneal dialysis was also noted.

Results

FIGURE 1. Frequency of PD Peritonitis Among PD First and PD Switch Patients within 6 months of PD Initiation

Conclusions

Majority of both PD first and PD switch patients were able to maintain PD practice 6 months post initiation. PD first patients experienced PD failure but none on the PD shift group. Among PD first patients, PD catheter malfunction in the form of PD catheter migration was significantly correlated to failure.

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