Parametric methods for estimating survival in continuous ambulatory peritoneal dialysis patients in the presence of competing events

Background Aim: In many studies, the survival of patients with chronic kidney disease who are treated with peritoneal dialysis technique has been considered, while this is possible in peritoneal dialysis patients to switch to another treatment. To achieve more accurate estimation of patient survival is necessary to examine all events. The purpose of this study is to estimate the cumulative incidence function (CIF) of events using competing risks method and then calculating the survival of patients treated with peritoneal dialysis. Methods Materials: This study includes 417 patients with chronic kidney disease who were under peritoneal dialysis between July 1996 and December 2009 in three centers in Tehran. We achieved their survival by 13 years follow-up time. We have collected patient demographic data and clinical characteristics. CIF of death and other events was estimated using the cause-specific hazard approach and direct approach. Parametric regression model was used to adjust the effects of covariates. The data analysis was performed using the R software. Results: In this study, the median follow-up time was 664 days. A total of 112 (26.9%) patients treated with peritoneal dialysis died before completing the study, and before the end of the study. One hundred sixty seven (40.0%) patients treated with peritoneal dialysis changed their dialysis method to hemodialysis or had renal transplantation . Conclusion: The effective risk factors on death CIF and other competing events CIF were diabetes mellitus, albumin, creatinine, diastolic blood pressure, urea and age, creatinine, diastolic blood pressure, respectively.