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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Hand function (HF) impairment may compromise peritoneal dialysis (PD) through touch contamination, increasing the risk of peritonitis and technique failure (TF) and subsequently the risk of death. We examined the association between motor HF and dexterity in PD patients and factors predicting adverse outcomes.
Cross-sectional analysis of adult, non-assisted PD patients conducted during 2010–2011. A simulated PD exchange was observed by a renal nurse, assessing any critical errors (CE) that could lead to touch contamination. HF was evaluated by grip strength, lateral pinch strength and tripod pinch strength, while dexterity was assessed using the Purdue Pegboard Test. The association between HF, dexterity measures, and CE was analyzed. Patients were followed until their first episode of peritonitis or exit-site infection (ESI) and until TF or death in dialysis.
A total of 91 patients were evaluated, 52.5% were male, with a mean age of 61±12.4 years. The median PD vintage was 28 [IQR 7–49] months. HF and dexterity measures declined with age and varied by sex in a linear regression model (Figure 1).
In the simulated PD exchange, 29 (31.8%) patients manifested CE. No significant differences were found in clinical variables for CE (Table 1A). When analyzing the residual deviation of each HF measure from the fitted value in the linear model, we observed lower grip and tripod strength, and mild lower dexterity measures in patients with CE (Table 1A). In the multivariate analysis adjusted for age and diabetes mellitus, a better tripod strength was independently associated with lower risk of CE (OR 0.80, 95% CI 0.64–0.96) (Table 1B).
The mean follow-up time in PD was 35 [IQR 21-59] months. During this time 71 (78.0%) patients presented at least one adverse event. Peritonitis was diagnosed in 50 (54.9%) patients in a mean time of 24 [IQR 9-39] months (rate 0.44 peritonitis/patient·year) and ESI in 38 (41.8%) patients in a mean time of 20 [IQR 7-31] months (rate 0.15 ESI/patient·year). Thirty-seven (40.7%) patients required transfer to hemodialysis due to TF and 31 (34.0%) patients died. In the univariate analysis, CE was not related to peritonitis, ESI infection or technique failure, but it seems to be related to death (p = 0.044). CE was also not related to the composite outcome of any infection (ESI or peritonitis) or any adverse outcome (ESI, peritonitis, TF or death) (Figure 2).
In the univariate analysis for mortality, age (HR 1.05, 95% CI 1.01-1.09), visual acuity (HR 0.12, 95% 0.02-0.56) and CE (HR 2.08, 95% CI 1.01-4.31) were significantly related to death (Table 2A). In the multivariate analysis, adjusted by sex and diabetes, CE was not related to mortality (HR 1.78, 95% CI 0.80 - 3.95). However, sex (HR 2.28, 95% CI 1.01-5.14) and visual acuity (HR 0.11, 95% CI 0.01-0.78) were independently related to mortality (Table 2B).
Impaired hand function, especially lower tripod pinch strength, was linked to an augmented probability of CE when performing PD. However, the presence of CE is not associated with PD-related infections in a long term follow-up of our cohort, suggesting additional factors contributing to these outcomes. Mortality was more closely related to functional status than CE, underscoring the need to explore other factors influencing adverse outcomes in dialysis patients.
