Patients undergoing assisted peritoneal dialysis to show a better technique survival: A competing risk analysis

To compare patient mortality and technique survival between patients undergoing assisted peritoneal dialysis (aPD) and self-care peritoneal dialysis (sPD).

Patients who underwent peritoneal dialysis (PD) at the dialysis center of Second Affiliated Hospital of Soochow University from January 1, 2012 to December 31, 2016, were included and followed to December 31, 2019. Subjects were divided into aPD and sPD groups according to whether the patient could independently complete the PD procedure. Differences in mortality and technique failure rates were compared using competing risk analysis.

A total of 384 patients were included in this study, with 274 patients in the sPD group and 110 patients in the aPD group. The multivariate competing risk regression analysis revealed that age (HR 1.03,95%CI 1.01-1.05, P < .001), aPD (HR 1.84,95%CI 1.10-3.08, P = .02), diabetes (HR 1.51, 95%CI 1.00-2.30, P = .05), residual renal function (HR 0.89, 95%CI 0.82-0.97, P = .005) and serum albumin level (HR 0.92, 95% CI 0.89-0.96, P < .001) were the independent risk factors for mortality. Besides, technique failure in aPD patients was lower than in the sPD group (HR 0.85, 95% CI 0.68-0.97, P = .03).

These results found that aPD patients had higher mortality rates but lower technique failure rates than sPD patients. Higher mortality in aPD is probably related to the negative selection of the more comorbid patients. ​ ​.