Original ©2013 Dustri-Verlag Dr. K. Feistle ISSN 0301-0430 DOI 10.5414/CN107711 e-pub: July 2, 2013 Received March 26, 2012; accepted in revised form April 10, 2013 Correspondence to Dr. Yener Koc Clinic of Nephrology, Sisli etfal Research and Educational Hospital, Istanbul, Turkey dryenerkoc@yahoo.com Key words survival – peritonitis – peritoneal dialysis Clinical outcomes and mortality in peritoneal dialysis patients: a 10-year retrospective analysis in a single center Abdulkadir Unsal, Yener Koc, Taner Basturk, Tamer Sakaci, Elbis Ahbap, Ayse Sinangil, Sennur Kose Budak, Mustafa Sevinc, Ekrem Kara and Baris Doner Clinic of Nephrology, Sisli etfal Research and Educational Hospital, Istanbul, Turkey Abstract. Aim: To evaluate the clinical outcome, identify predictors of patient and technique survival in our peritoneal dialysis (PD) patients in the western region of Tur- key. Methods: We included all patients who initiated therapy between 2001 and 2010. So- cio-demographic characteristics such as who helped to administer the PD as well as condi- tions under which PD was chosen by patients were investigated from patients’ iles. Hemo- dialysis (HD) history and duration, addition- al systemic diseases, and end-stage renal dis- ease etiologies of all patients were recorded. Clinical data such as blood pressure, amount of ultrailtration, and laboratory parameters were evaluated before initiation of PD and during the last monitoring period. Infectious complications and their incidences were in- vestigated. Patient and technique survival were investigated for every patient. Results: 322 patients started PD treatment during the study period. 23 patients were excluded. Data from the remaining 299 patients (167 female, mean follow-up time 38.5 ± 26.8 months, mean age 44.7 ± 15.9 years) were evalu- ated retrospectively. It was determined that 87.3% of the patients made their PD ex- changes without help from anyone. 79.9% of patients chose PD as their personal pref- erence. 48 patients had HD history before PD. Peritonitis incidences and catheter exit site/tunnel infection attacks were 27 ± 23 and 32.3 ± 24.9 patient-months, respectively. During the follow-up period, 199 patients (80 patients transferred to HD, 78 patients died, and 41 patients had transplantation) were withdrawn from PD. The most frequent causes of death were cardiovascular events and peritonitis and/or sepsis, whereas most frequent causes of transfer to HD were peri- tonitis and/or sepsis. Mean survival time was 49.9 ± 2.6 months. The estimation of survival rate was 85.2%, 66.5% and 45.3% at 1, 3, and 5 years, respectively. Preference for PD (RR: 4.77, p < 0.001), presence of HD history (RR: 2.08, p = 0.04), presence of diabetes mellitus (RR: 2.13, p = 0.01), low pretreatment serum albumin (RR: 0.32, p < 0.001), and low serum parathormone lev- els at last visit (RR: 0.99, p = 0.04) were pre- dictors of mortality. Mean technique survival duration was 48.5 ± 2.4 months. The estima- tion of technique survival by Kaplan-Meier analyses was 92%, 67% and 43% at 1, 3, and 5 years, respectively. Technique survival was associated with preference for PD (RR: 0.45, p < 0.001), presence of diabetes mel- litus (RR: 1.92, p = 0.003), and pretreatment serum albumin levels (RR: 0.58, p = 0.003). Conclusion: Patient survival in the presented institute is similar to that reported in Western countries. Compulsory choice of PD, pres- ence of HD history, presence of diabetes, low pretreatment serum albuminm, and low serum parathormone levels at last visit were the strongest predictors of death. Risk fac- tors for technique failure were compulsory choice of PD, presence of diabetes, low pre- treatment serum albumin. Introduction Peritoneal dialysis (PD) is a popular mo- dality of renal replacement therapy because of its lower cost [1], better preservation of residual renal function (RRF) [2], and high health-related quality of life (HRQOL) [3]. In addition, due to the home-based nature of this modality, it is advantageous over hemo- dialysis (HD). Despite these beneits of PD, it is still controversial as to whether PD is su- perior to intermittent HD. PD patients have equal or better survival outcomes compared to HD patients in the irst 2 – 3 years on di- alysis [4]. PD patients have much higher risk for premature death than the general popula- tion [5]. The reasons for high mortality may be multifactorial including older age, low RRF, increased peritoneal transport status, increased incidence of co-morbid diseases Clinical Nephrology, Vol. 80 – No. 4/2013 (270-279)