Long-Term Follow-Up of peritoneal dialysis for chronic kidney disease

Abstract

Background: Peritoneal dialysis (PD) is an established renal replacement modality for chronic kidney disease, but its long-term trajectory beyond the first one to two years of treatment is less well characterized than its early outcomes.

Objective: This study reports a long-term, single-center follow-up of adults treated with PD for chronic kidney disease, describing patient and technique survival, peritonitis incidence, and peritoneal membrane transport drift over a five-year observation window.

Methods: A retrospective cohort of 148 adults beginning continuous ambulatory or automated PD was followed for up to five years, with peritoneal transport status assessed by standardized equilibration testing and peritonitis defined and managed according to prevailing society guidance.

Results: Patient survival declined from 96% at one year to 73% at five years, while technique survival fell more steeply, from 90% to 53% over the same interval, driven chiefly by ultrafiltration failure and relapsing peritonitis rather than death. Peritonitis incidence rose from 0.32 to 0.61 episodes per patient-year, and membrane transport drifted toward higher solute transport in patients with a peritonitis history.

Conclusion: Long-term technique survival on PD depends substantially on active peritonitis prevention and monitoring of peritoneal membrane transport drift, and should be tracked as an outcome distinct from patient survival.