Survival analysis of Iranian patients undergoing continuous ambulatory peritoneal dialysis using cure model

Peritoneal dialysis is one of the most prevalent types of dialysis prescribed to the patients suffering from renal failure. Studies on the factors affecting the survival of these patients have mainly used log-rank test and Cox analysis. The present study aimed to investigate the risk factors affecting short- and long term survival of patients on continuous ambulatory peritoneal dialysis (CAPD) using cure model.

The data obtained retrospectively from 20 medical centers in Iran, between 1996 and 2009. All patients with renal failure who had been treated by CAPD and followed at least 3 months were included in the study. The STATA (11.0) software and CUREREGR module were used for survival analysis using cure model.

Totally 2006 patients were included in this study. The major reasons for renal failure were hypertension (35.4%) and diabetes (33.6%). The median of survival time was 4.8 years with a 95% confidence interval of 4.3 to 5.6 years. The percentage of long-lived patients surviving was 40% (95% CI: 32%, 47%). The analysis showed that the effect of diabetes, serum albumin level, age, diastolic blood pressure, and medical center was significant on the long-term survival of the patients. In addition, in short-term survival the effects of age, albumin, and medical center were significant.

By improving the quality of medical care in centers, nutritional status, controlling co-morbidities can help the patients on CAPD with better health and increase their short and long term survival.