[Risk factors associated with survival in patients in a peritoneal dialysis program]

Area of Science:

• Nephrology
• Internal Medicine
• Clinical Epidemiology

Background:

• Peritoneal dialysis (PD) is a crucial renal replacement therapy.
• Identifying mortality predictors in PD patients is essential for improving patient outcomes.
• Existing prognostic models for PD patients require refinement.

Purpose of the Study:

• To quantify mortality risk factors in peritoneal dialysis patients.
• To develop a prognostic index for predicting mortality risk at the initiation of dialysis.
• To assess the impact of identified risk factors on patient survival during PD.

Main Methods:

• Prospective study of 103 PD patients with a mean follow-up of 26 months.
• Multivariate Cox regression analysis to identify independent risk factors for mortality.
• Kaplan-Meier survival analysis based on a prognostic index derived from significant risk factors.

Main Results:

• Independent mortality risk factors identified: albumin < 4 g/dL (RR: 2.57), age > 65 years (RR: 3.10), and diabetes mellitus (RR: 4.36).
• Overall 5-year patient survival was 40%.
• Prognostic index effectively stratified patients into high, medium, and low-risk groups, showing significant differences in survival (e.g., 2-year survival: 40%, 73%, 100%).

Conclusions:

• Low albumin, advanced age, and diabetes mellitus are significant independent predictors of mortality in PD patients.
• A prognostic index incorporating these factors can effectively predict mortality risk and stratify patients.
• Addressing malnutrition and related factors is crucial for improving survival rates in PD patients.