대한신장학회

논문분류	춘계학술대회 초록집
제목	Survival in Peritoneal Dialysis Patients Who Initiated Immediately Dialysis After Catheter Implantation Using Percutaneous Method
저자	Young-Kyung Ko, Woong Cheon, Chae-Ho Lim, Won-Jae Shin, Young-Il Jo
출판정보	2018; 2018(1):
키워드	Peritoneal dialysis \| Survival \| Patient \| Technique \| Catheter
초록	Objectives: The aim of this study was to evaluate patient and technique survival in peritoneal dialysis (PD) patients who initiated immediately dialysis after catheter insertion using percutaneous catheter placement method without a break-in procedure. Methods: We conducted a retrospective study including all incident PD patients in our hospital who began PD therapy between January 2002 and August 2017. PD catheter (swan neck or non-swan neck Tenckhoff catheter with straight-end of intraperitoneal segment) were used and inserted by a nephrologist using percutaneous catheter placement method. PD therapy initiated immediately after catheter insertion without a break-in procedure. Demographic and clinical data on the initiation of PD and the clinical events including infectious complications, pericatheter leakage and catheter migration during the study period were collected. Patient survival rates and technique survival rates were calculated using Kaplan-Meier analysis. Results: One-hundred thirty five patients began PD during the study period, and 125 of these patients were included in the final analysis. During the follow-up period, 83 patients were withdrawn from PD. Reasons for discontinuing PD were transfers to hemodialysis(42.3%), kidney transplantation(18.8%), follow-up loss(21.7%), or death(17.6%). Causes of death included pneumonia(40.0%), cardiovascular events(20.0%), cerebrovascular event(20.0%), peritonitis(6.6%) and others(13.4%). The survival rates were 96.7%, 94.3%, 91.3%, 91.3% and 86.8% at 1, 2, 3, 4 and 5 years after PD initiation, respectively [Fig. 1-A]. In the Cox multivariate model, DM was related to patient survival. [Tab. 1]. The technique survival rates were 90.9%, 83.7%, 81.2%, 73.5% and 69.6% at 1, 2, 3, 4 and 5 years after PD initiation, respectively [Fig. 1-B]. The risk factor for technique survival was catheter migration (95% CI 0.113-0.701, p=0.006). Conclusions: In PD patients who initiated immediately dialysis after catheter implantation using percutaneous method, the survival rates and the technique survival rates were comparatively high in the present study. Figure-1. The survival rates for patient and technique.
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