-Original-

Risk Factors for Early Peritoneal Dialysis Discontinuation: Importance of Heart Failure

Kohsuke Terada, Yuichiro Sumi, Akio Hirama, Tetsuya Kashiwagi and Yukinao Sakai

Department of Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

Background: The number of patients on peritoneal dialysis (PD) in our hospital has increased during the past 5 years, but the number discontinuing PD has also increased. The purpose of this study was to identify the risk factors for PD discontinuation by analyzing the association between technical survival period (defined as the duration of PD) and various clinical factors.
Methods: We retrospectively investigated 87 patients who were started on PD at our hospital and attended regularly from April 2015 to March 2020, and we analyzed the association between technical survival period and various clinical factors. We also looked for associations between technical survival period and hospitalizations for heart failure, peritonitis, and exit-site infections among patients undergoing PD.
Results: The patients using renin-angiotensin-aldosterone system inhibitors (RASi) (P = 0.0218), those with left ventricular ejection fraction (LVEF) > 50% (P = 0.0194) when they started PD, and those with estimated glomerular filtration rate (eGFR) ≥ 6 (mL/min/1.73 m²) (P = 0.0013) at the initiation of PD showed significantly longer technical survival period, and those who were hospitalized for heart failure had significantly shorter period (P = 0.0008).
Conclusion: Treatment of RASi, LVEF > 50% and eGFR ≥ 6 mL/ min/1.73 m² when the initiation of PD and better volume control to prevent ultrafiltration failure and heart failure may improve technical survival period in patients undergoing PD.

J Nippon Med Sch 2022; 89: 72-80

Keywords
peritoneal dialysis, technical survival, heart failure, ultrafiltration failure, renin-angiotensin-aldosterone system inhibitors

Correspondence to
Yukinao Sakai, Department of Nephrology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
y-sakai@nms.ac.jp

Received, June 21, 2020
Accepted, March 17, 2021