Peritoneal dialysis technique survival at Tygerberg hospital in Cape Town, South Africa
Thesis (MPhil)--Stellenbosch University, 2017
Background: Peritoneal dialysis (PD) technique failure invariably occurs in patients with end-stage renal disease who are treated with this modality and results in increased morbidity and mortality. Various factors have been associated with the development of technique failure. Identifying such factors in a PD program is important to minimize the rates of technique failure and maintain patients on PD. Methods: In this retrospective study at Tygerberg Hospital in Cape Town, South Africa, we studied 170 patients who were started on CAPD and determined rates of technique and patient survival. Demographic, clinical and laboratory data were assessed to identify risk factors for these outcomes. Results: The median age of the patients was 36 years with the commonest cause of ESRD being glomerulonephritis. Only one patient had diabetes mellitus. Technique survival at 1, 2, 3 and 5 years was 78.5%, 60.4%, 54.5% and 39.6% respectively while patient survival was 90.8%, 86.8%, 83.6% and 63.5%. Peritonitis was the most common cause of technique failure. On multivariate analysis, the occurrence of peritonitis (OR 57.41, CI 11.19- 294.70, p < 0.001) and Black race (OR 6.43, CI 1.58-26.14, p = 0.009) increased the likelihood of technique failure. Other clinical and social factors were not significantly associated with the occurrence of technique failure. Conclusion: In our ESRD patients on PD, Black race and peritonitis were important factors in the development of technique failure. Concerted efforts are required to reduce peritonitis rates at our centre as this is the main cause of technique failure.
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