Author/Authors :
Hosseini, Mostafa Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences, Tehran , Roshani, Shahin Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences, Tehran , Ataei, Neamatollah Department of Pediatric Nephrology - Children’s Hospital Medical Center - Tehran University of Medical Sciences, Tehran , Hama Rahim Fattah, Fattah University of Sulaimani. Sulaimani, Iraq , Gubari, Mohammed I M Community Health Department - Technical College of Health - Sulaimani Polytechnic University - Sulaimani, Iraq , Jones, Michael E Division of Genetics and Epidemiology - The Institute of Cancer Research - London, UK , Najafi, Iraj Shariati Hospital - Tehran University of Medical Sciences, Tehran , Darabi, Fatemeh Department of Public Health - Asadabad School of Medical Sciences, Asadabad , Kalak, Darvishnoori Department of Anthropology - Faculty of Social Sciences - Islamic Azad University Central Tehran Branch , Fazel, Mojtaba Pediatric Department - Valiasr Hospital - Tehran University of Medical Sciences, Tehran , Yaseri, Mehdi Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences, Tehran , Yousefifard, Mahmoud Faculty of Medicne - Iran University of Medical Sciences, Tehran
Abstract :
Background: Statistics have shown that the rate of technical failure in peritoneal dialysis (PD) is greater than hemodialysis. In this regard, the present study is aimed to determine the prevalence and risks factors of technique failure of PD in Iranian children using the country’s computerized PD data registry system. Materials and Methods: Data of 405 PD patients younger than 20 years old were extracted from Iranian PD registry. The joint models of longitudinal and time-to-event data were used to assess independent risk factors of PD technique failure. Results: PD technique failure occurred in 17.3% of the patients. 1 ng/ml increase in the baseline level of ferritin and 1 mmHg increase in the baseline systolic blood pressure will result in 0.11% (Hazard Ratio [HR]=1.0011; p=0.001), and 1.25% (HR=1.0125; p=0.046) increase in the risk of PD technique failure, respectively. In addition, 1 g/dl decrease in the baseline hemoglobin will cause a 16.25% increase in the risk of PD technique failure (HR=0.8602; p=0.026). Finally, 1 mg/l decrease in the blood urea nitrogen over time after starting PD will result in 1.75% increase in the risk of PD technique failure (HR=0.9829; p=0.006). Conclusion: The findings from this study showed that an increase in ferritin as well as systolic blood pressure at the beginning of PD increase the risk of technique failure. Furthermore, an increase in the hemoglobin level at the beginning of PD as well as an increase in the blood urea nitrogen over time after starting PD have protective impacts on pediatric PD technique failure.
Keywords :
Dialysis , Pediatrics , Renal Replacement Therapy , Technique failure
