title: Continuous ambulatory peritoneal dialysis in Limpopo province, South Africa: predictors of patient and technique survival.
abstract: ♦
  
  
  OBJECTIVE
  Continuous ambulatory peritoneal dialysis (CAPD) is not a frequently used modality of dialysis in many parts of Africa due to several socio-economic factors. Available studies from Africa have shown a strong association between outcome and socio-demographic variables. We sought to assess the outcome of patients treated with CAPD in Limpopo, South Africa. ♦
  
  
  METHODS
  This was a retrospective study of 152 patients treated with CAPD at the Polokwane Kidney and Dialysis Centre (PKDC) from 2007 to 2012. We collected relevant demographic and biochemical data for all patients included in the study. A composite outcome of death while still on peritoneal dialysis (PD) or CAPD technique failure from any cause requiring a change of modality to hemodialysis (HD) was selected. The peritonitis rate and causes of peritonitis were assessed from 2008 when all related data could be obtained. ♦
  
  
  RESULTS
  There were 52% males in the study and the average age of the patients was 36.8 ± 11.4 years. Unemployment rate was high (71.1%), 41.1% had tap water at home, the average distance travelled to the dialysis center was 122.9 ± 78.2 kilometres and half the patients had a total income less than USD ($)180 per month. Level of education, having electricity at home, having tap water at home, body mass index (BMI), serum albumin and hemoglobin were significantly different between those reaching the composite outcome and those not reaching it (p < 0.05). The overall peritonitis rate was 0.82/year with 1-year, 2-year and 5-year survival found to be 86.7%, 78.7% and 65.3% (patient survival) and 83.3%, 71.7% and 62.1% (technique survival). Predictors of the composite outcome were BMI (p = 0.011), serum albumin (p = 0.030), hemoglobin (p = 0.002) and more than 1 episode of peritonitis (p = 0.038). ♦
  
  
  CONCLUSIONS
  Treatment of anemia and malnutrition as well as training and re-training of CAPD patients and staff to prevent recurrence of peritonitis can have positive impacts on CAPD outcomes in this population.
authors: Polokwane Kidney and Dialysis Centre, Pietersburg Provincial Hospital, Polokwane, Limpopo, South Africa; South African National Bioinformatics Institute/Medical Research Council of South Africa Bioinformatics Unit, University of the Western Cape; and Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, South Africa.
authors: Ramon A Tamayo
authors: RA
authors: Isla
authors: Polokwane Kidney and Dialysis Centre, Pietersburg Provincial Hospital, Polokwane, Limpopo, South Africa; South African National Bioinformatics Institute/Medical Research Council of South Africa Bioinformatics Unit, University of the Western Cape; and Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, South Africa.
authors: Darlington
authors: D
authors: Mapiye
authors: Polokwane Kidney and Dialysis Centre, Pietersburg Provincial Hospital, Polokwane, Limpopo, South Africa; South African National Bioinformatics Institute/Medical Research Council of South Africa Bioinformatics Unit, University of the Western Cape; and Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, South Africa.
authors: Charles R
authors: CR
authors: Swanepoel
authors: Polokwane Kidney and Dialysis Centre, Pietersburg Provincial Hospital, Polokwane, Limpopo, South Africa; South African National Bioinformatics Institute/Medical Research Council of South Africa Bioinformatics Unit, University of the Western Cape; and Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, South Africa.
authors: Nadiya
authors: N
authors: Rozumyk
authors: Polokwane Kidney and Dialysis Centre, Pietersburg Provincial Hospital, Polokwane, Limpopo, South Africa; South African National Bioinformatics Institute/Medical Research Council of South Africa Bioinformatics Unit, University of the Western Cape; and Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, South Africa.
authors: Jerome E
authors: JE
authors: Hubahib
authors: Polokwane Kidney and Dialysis Centre, Pietersburg Provincial Hospital, Polokwane, Limpopo, South Africa; South African National Bioinformatics Institute/Medical Research Council of South Africa Bioinformatics Unit, University of the Western Cape; and Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, South Africa.
authors: Ikechi G
authors: IG
authors: Okpechi
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends
keywords: Africans; CAPD; anemia; outcome; peritonitis; socio-economic status