Survival Analysis of Continuous Ambulatory Peritoneal Dialysis Patients at a Tertiary Specialty Center, 2021-2023

Background: Patient and technique survival is most challenging during the first year of continous ambulatory peritoneal dialysis (CAPD). This study analyzed first-year patient and technique survival among continuous ambulatory peritoneal dialysis patients initiated at a tertiary specialty center from 2021 to 2023. Methods: Incident CAPD patients were followed up for one year. Technique failure was defined as transferring to hemodialysis (HD) for more than 30 days. Mortality was defined as death from any cause. Kaplan-Meier survival function analysis was used to determine patient and technique survival. Binary logistics regression identified significant factors associated with mortality and technique failure. The Charlson Comornidity Index (CCI) was accessed through the mobile application MDCalc. Results: In 643 incident CAPD patients, increased mortality was significantly associated with advanced age (p<0.0001), Z-Package non enrollment (p=0.0006), severe CCI score (p=0.0002), hypertensive nephrosclerosis (p=0.0037), oliguria (p=0.0287), 4 daily exchnages (p=0.0001) and automated peritoneal dialysis use 3x/year (p=0.0008). For technique failure, Z-Package non enrollment (p=0.0001) and 4 daily exchnages (p=0.0021) were significant risk factors. Cardiovascular events was the leading cause of death (50%), and PD related infection was the leading cause of technique failure (73.42%). Patient survival rates declined from 99.70% at one month to 91.80% at 12 months, while technique survival rates declined from 99.40% to 86.80% over the same period. Conclusion: Patient and technique survival rates declined over a year. Z-Package non enrollment was a risk factor for both mortality and technique failure in the first year of CAPD.