Predictors of Patient Survival in Continuous Ambulatory Peritoneal Dialysis 10-Year Experience in 2 Major Centers in Tehran

Introduction. Many factors have been proposed to be associatedwith higher mortality in patients on continuous ambulatoryperitoneal dialysis (CAPD). However, the relative importance ofthese factors may differ among patients with different characteristics.We evaluated survival of patients on CAPD and its influencingfactors in Iran.Materials and Methods. We enrolled 282 patients on CAPD between1996 and 2006 at 2 major CAPD centers in Tehran. Patient survivalwas investigated during this period. Demographic characteristics,laboratory data, dialysis adequacy parameters, residual renalfunction, peritoneal transport characteristics, and nutritional statuswere assessed as potential predictors of the outcome.Results. The mean duration of follow-up was 18.4 ± 14.5 months.Sixty patients (21%) died during the studied period. In univariateanalysis, age, body mass index, history and duration of hemodialysisbefore CAPD, diabetes mellitus, blood pressure, patient selectioncriteria, edema, peritonitis, renal residual function, urine volume,dialysis adequacy, and serum levels of cholesterol, triglyceride,intact parathyroid hormone, calcium, and albumin were predictorsof patient survival. Multivariate analysis demonstrated that oldage, diabetes mellitus, prior hemodialysis longer than 7 months,low serum albumin, calcium, trigelyceride, and parathyroidhormone levels independently predicted mortality, while the useof angiotensin-converting enzyme inhibitors was associated witha better survival.Conclusions. This study showed that older patients on CAPDand diabetics are at a higher risk of mortality. On the other hand,nutritional and metabolic factors are other predictors of mortality.Especial concern should be applied to good nutrition and treatmentof comorbidities in these patients.