title: Predictors of death in patients on peritoneal dialysis: the Missouri Peritoneal Dialysis Study.
abstract: BACKGROUND
  The study was designed to identify predictors of death in subjects on peritoneal dialysis (PD).
  
  
  METHODS
  The population consisted of patients initiated on PD at the University of Missouri-Columbia and Dialysis Clinic Incorporated from January 1, 1990, through December 31, 1999. Baseline variables included demographics, clinical data, initial measures of nutritional status, adequacy, and transport characteristics. Co-morbidities were scored using a modified version of the Index of Coexistent Disease. Ongoing (during the course of PD) variables consisted of clinical characteristics and weighted time average of a number of laboratory, adequacy, and nutritional variables. The variables were screened using a univariate procedure, and then analyzed using stepwise logistic regression to evaluate their independent relation to death.
  
  
  RESULTS
  There were 105 men and 86 women--180 Caucasians, 10 African-American, 1 Asian, mean age 61 +/- 13 (SD) years, and mean duration of follow-up 21 +/- 18 months. Eighty-two patients suffered the outcome of death. Lean body mass (LBM) at the initiation of PD was negatively associated with the risk of death (p < 0.01). In addition, the need for a partner to perform PD, total morbidity count, and the summated severity score of all co-morbidities were associated with an increased risk of death. The analysis of ongoing variables revealed that serum phosphate (negative association, p = 0.02) and number of hospitalization days per month on PD (p = 0.0006) were associated with an increased risk of death.
  
  
  CONCLUSIONS
  Phosphate levels and LBM are strong negative predictors of death in PD subjects. Further, patients who need the assistance of a partner to perform PD have decreased survival.
authors.affiliation: Harry S. Truman Memorial Veterans' Hospital, Division of Nephrology, University of Missouri-Columbia, Columbia, MO, USA. htrivedi@mail.mcw.edu
authors.forename: Hariprasad
authors.initials: H
authors.lastname: Trivedi
authors.forename: Seng Hoe
authors.initials: SH
authors.lastname: Tan
authors.forename: Barbara
authors.initials: B
authors.lastname: Prowant
authors.forename: Ashley
authors.initials: A
authors.lastname: Sherman
authors.forename: C Gentiana
authors.initials: CG
authors.lastname: Voinescu
authors.forename: Jamal
authors.initials: J
authors.lastname: Atalla
authors.forename: Ramesh
authors.initials: R
authors.lastname: Khanna
authors.forename: Karl
authors.initials: K
authors.lastname: Nolph
mesh_terms: D000368:Aged; D001823:Body Composition; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality*; D010710:Phosphates / Q000097:blood; D011379:Prognosis; D012944:Social Support
chemical_list: D010710:Phosphates