DROPOUT IN PERITONEAL DIALYSIS OVER TWO TIME PERIODS: EXPERIENCE FROM ISSEMYM MEDICAL CENTER TOLUCA

 

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DROPOUT IN PERITONEAL DIALYSIS OVER TWO TIME PERIODS: EXPERIENCE FROM ISSEMYM MEDICAL CENTER TOLUCA

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Jesús Rafael
Sánchez Sustaita
Jesús Rafael Sánchez Sustaita rafaelsanchezsustaita@hotmail.com Centro Médico ISSEMyM Toluca Nephrology Toluca Mexico *
Patricia Fabiola Campirano González pfabi_campiranog@hotmail.com Centro Médico ISSEMyM Toluca Nephrology Toluca Mexico -
Alan Joel Rangel Puente Alan.rangel.puente@gmail.com Centro Médico Nacional Siglo XXI Nephrology Ciudad de México Mexico -
Joel Salvador Becerra Barrera becerrabarrerajs@outlook.es Centro Médico Nacional Siglo XXI Nephrology Ciudad de México Mexico -
Jose Manuel Rodriguez Chagolla jm.rodriguez.chagolla@gmail.com Centro Médico ISSEMyM Toluca Nephrology Toluca Mexico -
 
 
 
 
 
 
 
 
 
 

Peritoneal dialysis (PD) is a first-line kidney replacement therapy whose success depends on both clinical factors and the institutional context. Analyzing dropout causes and outcomes across different time periods allows the identification of improvement areas in clinical practice and health policies.
Objective: To compare the clinical characteristics and dropout causes of patients enrolled in a PD program across two periods (2021–2022 and 2023–2025) in a tertiary-level hospital.

Observational, retrospective, comparative study. A total of 214 patients on PD were included, divided into two cohorts: 2021–2022 (n=122) and 2023–2025 (n=92). Continuous variables were expressed as median and IQR, and categorical variables as frequencies and percentages. For comparisons, Kruskal-Wallis or Student’s t test were used for continuous variables, and χ² or Fisher’s exact test for categorical variables. A p value <0.05 was considered statistically significant.

Patients treated in 2023–2025 were younger (54 vs 62 years; p<0.001) and had a higher proportion on automated PD (76.1% vs 61.5%; p=0.03). They presented higher levels of creatinine (10.6 vs 6.9 mg/dl; p<0.001), phosphorus (5.7 vs 5.0 mg/dl; p=0.03), albumin (3.1 vs 2.7 g/dl; p=0.009), and PTH (255 vs 172 pg/ml; p=0.025). Mortality significantly decreased (31.5% vs 71.3%; p<0.001), while kidney transplantation increased (9.8% vs 0%; p<0.001) and loss of social security as a dropout cause also increased (39.1% vs 16.4%; p<0.001).


The 2023–2025 period demonstrated a substantial reduction in mortality and a rise in kidney transplantation rates, reflecting improved clinical outcomes. However, loss of social security emerged as a critical limitation for therapy continuity. These findings highlight the need to strengthen institutional support and public policies to ensure sustained healthcare coverage for patients with CKD.

Kewords