ASSISTED PERITONEAL DIALYSIS IN SINGAPORE: RISK OF CATHETER-RELATED INFECTION, HOSPITALISATION, AND TECHNIQUE FAILURE WCN26-AB-3736

 

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ASSISTED PERITONEAL DIALYSIS IN SINGAPORE: RISK OF CATHETER-RELATED INFECTION, HOSPITALISATION, AND TECHNIQUE FAILURE WCN26-AB-3736

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Ho
Tze Huay
Liu Yan Lun Allen liu.allen.yl@nhghealth.com.sg Khoo Teck Puat Hospital Renal Medicine Singapore Singapore -
Saifful Sri Fairuz Baizuri saifful.sri.fb@nhghealth.com.sg Khoo Teck Puat Hospital Renal Medicine Singapore Singapore -
Ho Tze Huay ho.janice.th@nhghealth.com.sg Khoo Teck Puat Hospital Renal Medicine Singapore Singapore *
Teoh Tse Yen Selene teoh.selene.ty@nhghealth.com.sg Khoo Teck Puat Hospital Renal Medicine Singapore Singapore -
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Assisted peritoneal dialysis (asPD) enables frail or dependent patients to receive home-based dialysis, but its impact on outcomes remains debated. Prior studies from Thailand and Hong Kong reported higher mortality in assisted patients, though data distinguishing family- from helper-assisted PD in a multiethnic population are limited.

We retrospectively analysed 113 incident PD patients (January 2023–March 2025) at a Singapore regional hospital, stratified into self-care PD (scPD), family-assisted PD, and helper-assisted PD. The primary outcome was the first peritonitis, expressed as episodes per patient-day at risk. Secondary outcomes included exit-site infection (ESI), hospitalisation, readmission, mortality, and technique failure (death, membrane failure, refractory infection, social reasons, pleuroperitoneal fistula). Kaplan–Meier (KM) survival with log-rank testing and Cox regression (adjusted for age, Charlson Comorbidity Index [CCI], and functional score) were applied.

Of 113 patients (mean age 60.3 ± 12.6 years; 57% male; 46% Chinese, 31% Malay, 9% Indian), 52 were on scPD, 42 family-assisted, and 17 helper-assisted PD. asPD patients were older (65.4 vs 54.2 years, p<0.001) and more often female (56% vs 33%, p=0.028). Diabetes accounted for 78% of ESKF.

In this first Singapore multiethnic cohort, asPD—whether by family or domestic helpers—was associated with higher peritonitis incidence and longer hospitalisation. Mortality was not significantly different, while technique failure appeared worse on unadjusted analysis but lost significance after adjustment. These findings highlight the need for structured support and targeted training for helpers to optimise outcomes in high-risk asPD patients.

Kewords