SP514
THE EFFECT OF PERITONEAL DIALYSIS MODALITY SELECTION AND NEW DIALYSIS SOLUTIONS ON PATIENTS SURVIVAL Free

INTRODUCTION AND AIMS: Peritoneal dialysis (PD) is an established treatment for ESRD patients; it has a variety of advantages, including autonomy and flexibility, as well as economic benefits in many countries compared to hemodialysis (HD). However, the long-term survival rate of PD remains poor and its correlated with alterations in peritoneal membrane during the time on PD which may lead to ultrafiltration failure or/and inadequate clearance of small solutes It has also been a crucial point the possibility of increased cardiovascular risk when prescribing automated peritoneal dialysis due to impaired sodium removal which may lead to fluid overload. The aim of the study was to retrospectively evaluate the possible effect of peritoneal dialysis modality and new dialysis solutions on patients’ survival.

METHODS: This is a single center retrospective study of 380 PD patients (m=225, f=155) conducted for the time period 1992 to 2017(25 years). From these patients 217 where on CAPD (continues ambulatory peritoneal dialysis) and 163 where on CCPD (continues cycler peritoneal dialysis). For the CAPD group the mean age was 63 ± 14 years and for the CCPD group was 64 ± 15 years (p=0,539). The incidence of diabetes between the two groups had no statistically significant difference (p=0,065), CAPD: 52/217 (24%) and CCPD: 53/163 (32%). Additionally, during this period 51 patients (CAPD 9 pts, CCPD 42 pts) used biocompatible peritoneal dialysis solutions low in GDPs, normal pH and bicarbonate as a buffer system. Subsequently the survival analysis of the PD patients was calculated by Kaplan Meier while the possible effect of any parameter in survival rates, such as the PD modality and the role of solution’s biocompatibility, which was evaluated by using Cox Regression analysis.

RESULTS: The age of our patients, the gender and the coexistence of diabetes did not differ between the CAPD and the CCPD group. The overall 5-year survival was 40% for the patients using CCPD and 29% for the patients using CAPD while the cumulative survival using was statistical significantly higher in the group using CCPD (Kaplan-Meier analysis, Log Rank test p=0,006). Furthermore Cox Regression analysis revealed that age (p<0,001), the presence of diabetes (p<0,001), CAPD modality (p=0,006) as well as the use of bioincompatible peritoneal dialysis solutions (p=0,014) were independent risk factors for the survival of peritoneal dialysis patients.

CONCLUSIONS: These results indicate that the presence of diabetes and the choice of PD modality may influence the survival of peritoneal dialysis patients. Furthermore, the use of new peritoneal dialysis solutions may improve the survival of PD patients possibly due to the decreased local and systemic effects induced by AGEs and GDPs.