Ch.06 peritoneal dialysis - ANZDATA · 2017. 9. 27. · 50 PERITONEAL DIALYSIS ANZDATA Registry 2003 Report NEW ZEALAND The annual stock and flow of patients during the period 1998

CHAPTER 6

PERITONEAL DIALYSIS

David Johnson

46

ANZDATA Registry 2003 ReportPERITONEAL DIALYSIS

2.6erugiF

stneitaPsisylaiDlaenotirePfowolFdnakcotS2002-8991

8991 9991 0002 1002 2002

ailartsuADPotwenstneitaP 027 057 587 238 867

tnemtaerTsisylaiDtsriF 993 414 524 784 674

)DH(sisylaiDsuoiverP 703 623 043 433 672

tnalpsnarTdeliaF 41 01 02 11 61

detnalpsnarT 221 29 221 011 141

shtaeD 692 903 982 213 433

detnalpsnarTreveN 682 392 082 103 523

tnalpsnarTsuoiverP 01 61 9 11 9

21>(tuOsrefsnarTtnenamreP shtnom ) 323 913 053 163 953

21(tuOsrefsnarTtnenamreP shtnom ) 66 48 68 77 96

21

47

ANZDATA Registry 2003 Report PERITONEAL DIALYSIS

New patients over the age of 65 yearsdecreased 4%, from 374 in 2001 to 358 in2002, in contrast to an increase of 17%in the preceding year. There was adecrease in the 25-34 year age group of45% (24 patients compared to 44 in 2001)and a 20% decrease in the 55-64 yearage group (147 compared to 184 patientsin 2001). There was a 6% increase in the45-54 year age group (124 patientscompared to 117 in 2001).There were 334 deaths (312 in 2001),(18.7 deaths per 100 patient years; 12.7%of patients at risk) (fig 3.6). For moredetail see Appendix II at Website(www.anzdata.org.au/ANZDATA/AnzdataReport/download.htm).

One hundred and forty one patientsreceived a transplant in 2002 comparedto 110 in 2001; 8% of all patients treated,14% of patients 65years were transplanted.

Permanent transfer (>12 months) tohaemodialysis was similar to last year,359 (20%) and 361 (20%) in 2001. Mosttransfers to haemodialysis werepermanent (359/444) (fig 6.2).

The primary renal disease of newpatients to peritoneal dialysis remainedsimilar to previous years (fig 6.8).

Figure 6.3

Figure 6.4

Stock and Flow of Peritoneal Dialysis PatientsNew Zealand 1998 - 2002

0

200

400

600

800

1000

1200Number of Patients

767Patients

New PatientsTransplantsPerm. TransferDeathsNo. Dialysing

98 99 00 01 02

Stock and Flow of Peritoneal Dialysis PatientsAustralia 1998 - 2002

0

500

1000

1500

2000

2500

3000Number of Patients

1770Patients

98 99 00 01 02

New PatientsTransplantsPerm. TransferDeathsNo. Dialysing

5.6erugiF

3002hcraM13tasisylaiDlaenotirePfodoirePsuounitnoC

shtnoM

6-0 21-7 81-31 42-91 03-52 63-13 24-73 84-34 06-94 27-16 48-37 69-58 801-79 > 901

ailartsuAstP984,31tnemtaerTts1 1883 4462 0481 5631 8111 286 035 014 794 572 831 85 52 62

stP416,61stnemtaerTllA 0305 7823 7322 0761 2921 808 526 184 775 813 251 07 92 83

dnalaeZweNstP757,3tnemtaerTts1 467 695 425 254 053 582 532 031 102 79 54 44 61 81

stP934,4stnemtaerTllA 959 427 626 415 893 133 562 441 322 011 65 64 81 52

48


Figure 6.6 Figure 6.7

3%10%

16% 19%

30%

16%

2.5% 0.8%2.5%

0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 >=85

Number (Total=768)

Age of New PD Patients 2002

No. Pats. 18 18 24 79 124 147 229 123 6

Australia

2% 5%10%

15%20%

30%

16%

1%1%

0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 >=85

Number (Total=1770)

Age of Dialysing PD Patients 31-Dec-2002

No. Pats. 24 42 82 182 257 359 523 283 18

Australia

8.6erugiF

2002-8991sisylaiDlaenotirePfowolFdnakcotS

spuorGegA 8991 9991 0002 1002 2002

*stneitaPweN

sraey41-00 81 )%2( 61 )%2( 51 )%2( 31 )%2( 81 )%5.2(

sraey42-51 91 )%3( 81 )%2( 62 )%3( 91 )%2( 81 )%5.2(

sraey43-52 14 )%6( 93 )%5( 06 )%8( 44 )%5( 42 )%3(

sraey44-53 96 )%01( 67 )%01( 76 )%8( 18 )%01( 97 )%01(

sraey45-54 011 )%51( 221 )%61( 021 )%51( 711 )%41( 421 )%61(

sraey46-55 151 )%12( 231 )%81( 871 )%32( 481 )%22( 741 )%91(

sraey47-56 222 )%13( 342 )%33( 012 )%72( 332 )%82( 922 )%03(

sraey48-57 88 )%21( 201 )%31( 301 )%31( 631 )%71( 321 )%61(

> sraey58 2 )%1

49


Figure 6.10

Figure 6.9

Figure 6.12

Figure 6.11

69%

30%19% 24% 21% 24%

27% 24% 24%

0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 >=85

Number (Total=1770)

PD Patients (%) of all Dialysis

Australia 31-Dec-2002

Number (Per Million) PD Patients

86.5 88.6 90.693.1 90.0

1998 1999 2000 2001 2002

Non Diabetic Diabetic

Australia 1998 - 2002

54%

18%9% 9% 8% 8% 8% 7% 11%

0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 >=85

Number (Total=607)

APD Patients (%) of all Dialysis

Australia 31-Dec-2002

Number (Per Million) APD Patients

11.6 13.920.3

25.830.8

1998 1999 2000 2001 2002


Australia 1998 - 2002

50


NNNNNEWEWEWEWEW Z Z Z Z ZEALANDEALANDEALANDEALANDEALAND

The annual stock and flow of patientsduring the period 1998 to 2002 is shown inFigures 6.2 and 6.4. Of the 4,439 treatedsince 1978, 767 (17%) were alive at 31December 2002, 255 (6%) had more thanfive years continuous treatment (fig 6.5).

Peritoneal dialysis accounted for 48% of alldialysis patients, and 77% of all patientsdialysing at home. Automated peritonealdialysis accounted for 17% of all peritonealdialysis patients in 2002, compared with16% in 2001, and 12% in 2000.

The age distribution of prevalent peritonealdialysis patients is shown in Figures 6.18and 6.19.

There were 289 new peritoneal dialysispatients in the calendar year 2002 (282 in2001). For 55%, peritoneal dialysis was theinitial dialysis treatment (fig 6.17 and 6.19).For more detail see Appendix III at Website(www.anzdata.org.au/ANZDATA/AnzdataReport/download.htm).

There were 123 deaths amongst prevalentperitoneal dialysis patients in 2002 (135 in2001) 16.6 deaths per 100 patient years,(12.0% of patients at risk; 14% 25-44 years,21% 45-64 years, 34% 65-84 years) (fig 3.6).For more detail see Appendix III at Website(www.anzdata.org.au/ANZDATA/AnzdataReport/download.htm).

Forty three patients were transplanted in2002 (37 in 2001), 6% of patients dialysed,8% of patients 65 years were transplanted.

The most common primary renal disease ofnew patients to peritoneal dialysis wasdiabetic nephropathy (47%) followed byglomerulonephritis (24%).

The proportion of patients in each grouptreated with peritoneal dialysis ranged from39% (35-44 years), 41% (45-54 years) to85% (0-14 years) and 100% (85-94 years)(fig 6.13).

Figure 6.13

Figure 6.14

Figure 6.16

Figure 6.15

85%

47% 46% 39% 41%49% 53%

64%

100%

0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 >=85

Number (Total=767)

PD Patients (%) of all Dialysis

New Zealand 31-Dec-2002

85%

25%

6% 11% 7% 8% 6% 5% 11%

0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 >=85

Number (Total=133)

APD Patients (%) of all DialysisNew Zealand 31-Dec-2002

Number (Per Million) APD Patients

9.4 13.520.9

28.8 33.7

1998 1999 2000 2001 2002


New Zealand 1998 - 2002

Number (Per Million) PD Patients

166.1 174.9 176.2 184.2194.7

1998 1999 2000 2001 2002


New Zealand 1998 - 2002

51


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2002-8991sisylaiDlaenotirePfowolFdnakcotS

spuorGegA 8991 9991 0002 1002 2002

*stneitaPweN

sraey41-00 5 )%2( 5 )%2( 6 )%2( 6 )%2( 8 )%3(

sraey42-51 9 )%4( 5 )%2( 4 )%1( 21 )%4( 5 )%2(

sraey43-52 91 )%8( 11 )%4( 31 )%5( 61 )%5( 32 )%8(

sraey44-53 12 )%8( 22 )%8( 42 )%9( 03 )%01( 62 )%9(

sraey45-54 44 )%71( 65 )%12( 94 )%91( 94 )%71( 06 )%12(

sraey46-55 28 )%23( 87 )%03( 08 )%13( 27 )%62( 57 )%62(

sraey47-56 06 )%42( 16 )%32( 65 )%22( 17 )%62( 96 )%42(

sraey48-57 31 )%5( 42 )%9( 92 )%11( 42 )%9( 12 )%7(

> sraey58 1 )%1

52


RELATIONSHIP OF BMI TO WEEKLY DIALYSATE VOLUME

Figure 6.20

The box is split at the median, with the length of the box known as the inter-quartile range (the distance between 25th and 75thpercentile). Fifty percent of the data lies in the box. The median weekly dialysate volume for patients on peritoneal dialysis hasremained reasonably constant throughout the surveys for most BMI groups. A large number of outliers are occurrent in theAustralian population with a lower BMI which could be as a result of a number of other determinants.

0

20

40

60

80

100

120

140

160

180

200

LITR

ES

Mar-99 Sep-99 Mar-00 Sep-00 Mar-01 Sep-01 Mar-02 Sep-02 Mar-03

0

20

40

60

80

100

120

140

160

180

200

LITR

ES


0

20

40

60

80

100

120

140

160

180

200

LITR

ES


0

20

40

60

80

100

120

140

160

180

200

LITR

ES


0

20

40

60

80

100

120

140

160

180

200

LITR

ESMar-99 Sep-99 Mar-00 Sep-00 Mar-01 Sep-01 Mar-02 Sep-02 Mar-03

0

20

40

60

80

100

120

140

160

180

200

LITR

ES


0

20

40

60

80

100

120

140

160

180

200

LITR

ES


0

20

40

60

80

100

120

140

160

180

200

LITR

ES


Australia 1998-2003 New Zealand 1998-2003

BMI 30 kg/m2 BMI >30 kg/m2

BMI 25-29.9 kg/m2

BMI 20-24.9 kg/m2

BMI

53


PERITONITIS

Figure 6.22

Australian median peritonitis free survival has increased to 18.4 months overall, with 30%of patients completely free of peritonitis at three years. In New Zealand the survival timewas 14.5 months (23% of patients) (fig 6.21). As noted in previous reports there is astrong association between ethnicity and peritonitis free survival (fig 6.23). In this Report,for the first time, we report on peritonitis free survival in patients on home automatedperitoneal dialysis (fig 6.24). The median survival peritonitis for Australian home auto-mated peritoneal dialysis patients was 21.3 months, and was 15.7 months for New Zealandhome automated peritoneal dialysis patients.

First PD Treatment to First Peritonitis Related to Age at Entry 1998 - 2002

0%

20%

40%

60%

80%

100%

3 6 9 12 24Months

0%

20%

40%

60%

80%

100%

0-14 (81) 15-34 (315) 35-44 (972) 55-64 (791) 65-74 (1140) >=75 (574)

% Survival

Age Group

Australia

First PD Treatment to First Peritonitis Related to Age at Entry 1998 - 2002

0%

20%

40%

60%

80%

100%

3 6 9 12 240%

20%

40%

60%

80%

100%

0-14 (29) 15-34 (118) 35-44 (376) 55-64 (390) 65-74 (316) >=75 (119)

% Survival

Age Group

New Zealand

12.6erugiF

sitinotirePfoedosipEtsriFottnemtaerTDPtsriF2002-ceD-13ot8991yrtnEtaegAotdetaleR

lavivruSspuorGegA

llA41-00 43-51 45-53 46-55 47-56 > 57

ailartsuA 18=n 513=n 279=n 197=n 0411=n 475=n 3783=nshtnom3 17 + 1.5 )15( 09 + 7.1 )462( 68 + 1.1 )577( 78 + 2.1 )436( 48 + 1.1 )168( 58 + 6.1 )724( 58 + 6.0 )2103(

shtnom6 75 + 8.5 )53( 08 + 4.2 )102( 57 + 5.1 )475( 57 + 6.1 )294( 47 + 4.1 )766( 47 + 9.1 )633( 57 + 7.0 )5032(

shtnom9 84 + 1.6 )32( 07 + 8.2 )941( 86 + 6.1 )964( 76 + 8.1 )383( 66 + 5.1 )715( 86 + 1.2 )162( 76 + 8.0 )2081(

raey1 73 + 8.6 )81( 36 + 1.3 )611( 16 + 8.1 )173( 06 + 9.1 )503( 85 + 7.1 )693( 06 + 3.2 )991( 06 + 9.0 )5041(

sraey2 73 + 8.6 )7( 14 + 7.3 )14( 44 + 0.2 )441( 14 + 2.2 )811( 04 + 9.1 )851( 93 + 8.2 )75( 14 + 0.1 )525(

sraey3 - 03 + 2.4 )51( 13 + 4.2 )44( 03 + 5.2 )14( 82 + 0.2 )75( 23 + 3.3 )71( 03 + 2.1 )871(

dnalaeZ.N 92=n 811=n 673=n 093=n 613=n 911=n 8431=nshtnom3 96 + 6.8 )02( 98 + 9.2 )201( 68 + 2.7 )413( 58 + 9.1 )413( 78 + 9.1 )252( 78 + 1.3 )59( 68 + 9.0 )7901(

shtnom6 74 + 5.9 )11( 87 + 9.3 )57( 17 + 5.7 )732( 07 + 4.2 )832( 37 + 6.2 )091( 57 + 1.4 )17( 27 + 3.1 )228(

shtnom9 24 + 6.9 )9( 07 + 5.4 )36( 26 + 7.6 )971( 85 + 6.2 )281( 46 + 9.2 )451( 86 + 6.4 )95( 26 + 4.1 )646(

raey1 24 + 6.9 )7( 06 + 0.5 )54( 45 + 1.6 )641( 15 + 7.2 )241( 65 + 1.3 )311( 75 + 1.5 )44( 45 + 5.1 )794(

sraey2 - 53 + 0.7 )01( 53 + 6.2 )44( 63 + 9.2 )05( 73 + 4.3 )64( 82 + 4.5 )01( 43 + 6.1 )161(

sraey3 - 52 + 0.7 )3( 42 + 1.3 )8( 12 + 1.3 )51( 42 + 6.3 )71( 22 + 8.5 )5( 32 + 8.1 )84(

lavivruS% ± ksirtasrebmuNdna.E.S

54


Figure 6.23

First PD Treatment to First Peritonitis Related to Race

0%

20%

40%

60%

80%

100%

3 6 9 12 24Months

Australia 1993-1997

Aboriginal/Torres StMaori/Pac Isl

Caucasoid 35-54 yrs 55-64 yrs35-54 yrs55-64 yrs


0%

20%

40%

60%

80%

100%

3 6 9 12 24Months

Australia 1998-2002

Aboriginal/Torres StMaori/Pac Isl

Caucasoid 35-54 yrs 55-64 yrs

35-54 yrs

55-64 yrs


0%

20%

40%

60%

80%

100%

3 6 9 12 24Months

New Zealand 1993-1997

Caucasoid 35-54 yrs 55-64 yrsMaori/Pac Isl 35-54 yrs 55-64 yrs


0%

20%

40%

60%

80%

100%

3 6 9 12 24Months

New Zealand 1998-2002

Caucasoid 35-54 yrs 55-64 yrs

Maori/Pac Isl 35-54 yrs 55-64 yrs

42.6erugiF

sitinotirePfoedosipEtsriFottnemtaerTDPAemoHtsriF2002-ceD-13ot8991yrtnEtaegAotdetaleR

lavivruSspuorGegA

llA41-00 43-51 45-53 46-55 47-56 > 57

ailartsuA 45=n 731=n 282=n 491=n 452=n 521=n 6401=nhtnom1 38 ± 1.5 44 69 ± 6.1 821 59 ± 3.1 462 79 ± 3.1 281 59 ± 3.1 732 89 ± 4.1 711 59 ± 7.0 279shtnom3 37 ± 1.6 63 68 ± 1.3 901 68 ± 1.2 622 98 ± 3.2 851 78 ± 2.2 202 19 ± 6.2 101 78 ± 1.1 238shtnom6 06 ± 0.7 42 37 ± 0.4 87 57 ± 7.2 561 08 ± 0.3 511 87 ± 7.2 651 88 ± 1.3 68 77 ± 4.1 426shtnom9 75 ± 2.7 12 56 ± 5.4 65 76 ± 1.3 221 27 ± 6.3 19 27 ± 1.3 511 18 ± 0.4 95 07 ± 6.1 464raey1 15 ± 6.7 51 06 ± 8.4 34 16 ± 3.3 88 46 ± 1.4 26 76 ± 4.3 58 67 ± 5.4 84 46 ± 7.1 143sraey2 93 ± 6.8 6 04 ± 6.5 91 44 ± 1.4 33 64 ± 2.5 41 15 ± 4.4 82 25 ± 8.6 01 64 ± 2.2 011

dnalaeZ.N 72=n 62=n 45=n 33=n 32=n 41=n 771=nhtnom1 98 ± 0.6 42 58 ± 1.7 22 49 ± 1.3 15 88 ± 8.5 72 69 ± 2.4 22 39 ± 1.7 21 19 ± 2.2 851shtnom3 47 ± 5.8 91 08 ± 8.7 81 58 ± 9.4 54 88 ± 8.5 62 28 ± 2.8 71 67 ± 9.11 9 28 ± 9.2 431shtnom6 94 ± 0.01 11 17 ± 4.9 31 97 ± 6.5 63 08 ± 2.7 22 77 ± 1.9 41 67 ± 9.11 7 37 ± 5.3 301shtnom9 44 ± 1.01 8 56 ± 3.01 01 76 ± 8.6 72 27 ± 4.8 61 56 ± 1.11 9 65 ± 6.51 5 36 ± 9.3 57raey1 83 ± 5.01 5 15 ± 8.11 7 76 ± 8.6 81 76 ± 4.9 01 65 ± 3.21 6 03 ± 4.51 2 65 ± 3.4 84

ksirtasrebmuNdna.E.S±lavivruS%

55


TECHNIQUE FAILURE(CENSORED FOR DEATH OR TRANSPLANTATION)

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ecnaraelcetulosetauqedanI 191 01 74 1noitartlifartludiulfetauqedanI 051 8 13 1

eruliaFsisylaiDlatoT )%91(143 )%12(81 )%71(87 )%51(2

kaeletasylaiD 821 91 23 4kcolbretehtaC 81 - 7 -tuollefretehtaC 6 - - -

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xarohtordyH - - 1 -muenotirepomeaH 1 1 - -

amedeolatorcS 1 - - -

eruliaFlacinhceTlatoT )%61(782 )%43(92 )%51(07 )%13(4

eracfleseganamotelbanU 951 7 22 -ecnereferptneitaP 613 61 38 1

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)%52(665 )%61(81 )%03(181 )%62(6

ecnaraelcetulosetauqedanI 743 31 731 7noitartlifartludiulfetauqedanI 161 11 55 2

eruliaFsisylaiDlatoT )%32(805 )%12(42 )%23(291 )%93(9

kaeletasylaiD 551 81 74 4kcolbretehtaC 83 2 5 -tuollefretehtaC 11 - 2 -

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xarohtordyH 4 - - -muenotirepomeaH 1 - - -

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eracfleseganamotelbanU 491 7 03 1ecnereferptneitaP 546 63 321 2

snosaeRlaicoSlatoT )%83(938 )%83(34 )%52(351 )%31(3

Interestingly, in Australia, patientpreference as a cause for transferhas risen dramatically from 316(17%) in the era 1997 to 2000, to645 (28%) in the era 2000-2003. InNew Zealand the results weresimilar over the same period; 83(18%) and 123 (20%) beingrecorded in the two epochs.

Ethnicity is also associated with thecause of technique failure. Infec-tive reasons are attributed as thecause of technique failure for 52%of Aboriginal patients, compared to29% of Caucasians and 30% ofAsians. Similarly in New Zealand,infective reasons are attributed asthe cause of technique failure for41% of Maori and 46% of PacificIslanders, compared to 31% ofCaucasians and 31% of Asians.

In contrast social reasons accountfor only 20% of failures in Austral-ian Aborigines and in New Zealand19% of Maori’s and 22% ofPacific Islanders.

These failure rates related toinfection correlate with the ten-dency towards early peritonitis inthe indigenous populations (fig6.27).

56


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%53 %13 %03 %25 %92 %03 %53 %03 %23 %13 %23

etuloSdecudeRecnaraelC

001 834 74 22 654 - 8 5 522 303 835%11 %41 %41 %6 %41 - %51 %91 %51 %21 %31

etauqedanInoitartlifartlU

87 332 22 52 952 1 3 1 201 202 113%8 %7 %6 %6 %8 %01 %6 %4 %7 %8 %8

lacinhceT 701 405 93 26 005 2 4 4 112 693 116%11 %61 %11 %61 %51 %02 %8 %51 %51 %61 %51

laicoS 033 489 631 87 8601 4 91 9 254 638 4131%53 %23 %93 %02 %33 %04 %73 %33 %13 %33 %23

latoT 249 3113 843 683 2323 01 25 72 4541 8252 5504

dnalaeZweNevitcefnI 551 632 52 - 041 951 66 1 931 742 193

%73 %73 %13 - %13 %14 %64 %05 %33 %14 %73

etuloSdecudeRecnaraelC

97 501 61 - 36 28 32 - 58 89 481%91 %61 %02 - %41 %12 %61 - %02 %61 %71

etauqedanInoitartalifartlU

93 74 5 - 84 82 5 - 23 25 68%9 %7 %6 - %11 %7 %3 - %8 %9 %8

lacinhceT 65 29 41 - 96 64 91 - 75 88 841%31 %41 %71 - %51 %21 %31 - %31 %51 %41

laicoS 39 561 12 - 331 27 13 1 111 811 852%22 %62 %62 - %92 %91 %22 %05 %62 %02 %42

latoT 224 546 18 - 354 783 441 2 424 306 7601

45


Figure 6.28

Figure 6.29

ACHIEVED SOLUTE CLEARANCE

Figure 6.31

Figure 6.30

Figure 6.32

The median (interquartile range) total weekly Kt/Vwas 1.94 (1.60 to 2.25) for Australian patients and1.92 (1.65 to 2.24) for New Zealand patients. Thecorresponding values for total weekly creatinineclearances were 53.05 (44,17 to 66.67) and 47.44(41.00 to 56.68) L/week/1.73 m2, respectively. Totalsmall solute clearances were not appreciablyinfluenced by residual renal GFR (fig 6.28-6.30).However, higher prescribed dialysate volumes weremore likely to be associated with a total weeklyKt/V in excess of 1.8 (fig 6.31 and 6.32).

Relationship of Residual GFR to Kt/V

Achieved Kt/V March 2003

Litres / week / 1.73m2

Relationship of Residual GFR toCreatinine Clearance

Creatinine Clearance(Litres/Week) March 2003

Litres / week / 1.73m2

V/TKotRFGlaudiseRfopihsnoitaleR3002hcraM

RFGlaudiseR )latoT(V/TK I.C%59

tsuA< )833=n(nim/lm1 70.2 )39.2-12.1(

)939=n(nim/lm1> 30.2 )82.3-87.0(

ZN< )681=n(nim/lm1 50.2 )39.2-71.1(

)014=n(nim/lm1> 77.1 )80.3-64.0(

etasylaiDfoemuloVotdetaleRV/TK3002hcraMdnalaeZweN

debircserPemuloVetasylaiD

)latoT(V/TKdeveihcA

< 8.1 8.1>

< keew/L65 )%36(841 )%73(78

> keew/L07 )%04(061 )%06(532

803 223

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58


PERITONEAL TRANSPORT STATUS

The Registry commenced collection of this data in April1999 in patients new to peritoneal dialysis, with the aim ofusing these measurements as another predictor of out-come.

Only 1,161 patients in Australia and 446 patients in NewZealand had data supplied: 68% of all new patients inAustralia and 71% of all new patients in New Zealand.

The mean D/P creatinine ratios tend to be higher thanexpected from the proposed international means ofTwardowski (Reference: Perit Dial Bull 1987:7:138-147).

Figure 6.33

Figure 6.34

PET D/P Creatinine at Four HoursNew PD Patients from 1-Apr-99 to 31-Mar-03

Australia New Zealand

Diabetic Non Diabetic


Mean + 1 SD 0.83 0.82 0.84 0.84

Mean 0.70 0.69 0.71 0.71

Mean – 1 SD 0.57 0.56 0.58 0.58

Peritoneal Transport Status New PD Patients 1-Apr-1999 to 31-Mar-2003 Australia New Zealand



High (> 0.81) 32 (10%) 77 (9%)

18 (10%) 26 (10%)

High Average (0.65-0.80) 164 (51%) 469 (56%)

115 (62%) 165 (63%)

Low Average (0.50-0.64) 120 (37%) 271 (32%)

44 (24%) 59 (22%)

Low (

59


TRANSPLANTATION IN PERITONEAL DIALYSIS PATIENTS

In Australia in patients receiving first cadaveric grafts, those who are onhaemodialysis had a higher frequency of delayed graft function (22%) thanthose on peritoneal dialysis (12%). (Figure 6.37)However, this did not have an effect on overall graft survival. (Figure 6.38)

Figure 6.36

Figure 6.37

12%

22%

PD HD

Delayed Graft Function 1993 - 2002According to Type of Dialysis

CD1 Grafts Australia

Chi-square p

Documents

Ch.06 peritoneal dialysis - ANZDATA · 2017. 9. 27. · 50 PERITONEAL DIALYSIS ANZDATA Registry 2003 Report NEW ZEALAND The annual stock and flow of patients during the period 1998