title: Outcome of peritoneal dialysis in cirrhotic patients with end-stage renal disease: a 24-years' experience in Taiwan.
abstract: BACKGROUND
  Use of peritoneal dialysis (PD) in liver cirrhosis patients with end-stage renal disease remains controversial. Moreover, the long-term outcome in cirrhotic patients is unclear. The aim of the present study was to analyze the outcome of cirrhotic patients treated with PD in our center during the past 24 years.
  
  
  METHODS
  We retrospectively reviewed the data of cirrhotic patients who received PD between 1984 and 2009. A group of noncirrhotic patients who were age- and sex-matched during the same period were selected as controls. Peritonitis rates, complications and outcomes were compared.
  
  
  RESULTS
  A total of 30 cirrhotic patients and 60 control patients were included in the analysis. Peritonitis-free survival did not differ between groups. Gram-positive organisms, especially coagulase-negative staphylococcus and streptococcus sp., were the major causes of peritonitis in the cirrhotic patients. Also in the cirrhotic patients, complications such as umbilical hernia, chronic hypotension and erythropoietin resistance were more common as compared with controls. An initially higher solute and water transport capacity was observed in the cirrhotic patients, which became comparable to controls by the end of the 2nd year of treatment. Serum albumin concentrations were lower in cirrhotic patients (p = 0.01), and the decline of renal Kt/V was slower in cirrhotic patients as compared to that of controls (p < 0.0001). There was no significant difference in patient and technique survival between the two groups.
  
  
  CONCLUSIONS
  Our study suggests that PD is an effective therapy with a comparable risk of peritonitis and solute clearance in liver cirrhosis patients with end-stage renal failure.
authors.affiliation: Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taiwan.
authors.forename: S-T
authors.initials: ST
authors.lastname: Huang
authors.forename: Y-W
authors.initials: YW
authors.lastname: Chuang
authors.forename: C-H
authors.initials: CH
authors.lastname: Cheng
authors.forename: M-J
authors.initials: MJ
authors.lastname: Wu
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.forename: T-M
authors.initials: TM
authors.lastname: Yu
authors.forename: K-H
authors.initials: KH
authors.lastname: Shu
mesh_terms: D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013624:Taiwan; D016896:Treatment Outcome