title: Recent analysis of status and outcomes of peritoneal dialysis in the Tokai area of Japan: the second report of the Tokai peritoneal dialysis registry.
abstract: BACKGROUND
  Early withdrawal within 3 years after starting peritoneal dialysis (PD) and PD-related peritonitis have been major obstacles preventing increases in the population of PD patients. To address these problems, we implemented education programs for medical staff. This study analyzed the recent status and outcomes of PD therapy, focusing on findings such as the incidence and prognosis of peritonitis as of 5 years after our last study.
  
  
  METHODS
  We investigated background, laboratory data and status of PD therapy, reasons for withdrawal from PD and incidental statements on peritonitis from 2010 to 2012 (R2), and compared findings with those from our last study of 2005-2007 (R1).
  
  
  RESULTS
  Early PD therapy withdrawal in R2 clearly improved to 44.7 %, compared with 50.9 % in R1. Peritonitis incidence improved slightly from once per 42.8 months/patient in R1 to once per 47.3 months/patient in R2. Notably, PD-related peritonitis as a cause of mortality improved markedly in R2, but outcomes of PD-related peritonitis did not change significantly between R1 and R2. In contrast, social problems increased as a reason for withdrawal from PD therapy.
  
  
  CONCLUSIONS
  Our efforts at education might have been useful for improving early withdrawal from PD and deaths attributable to PD-related peritonitis. However, since improvements to incidence of PD-related peritonitis were limited by education, further improvement in PD-related peritonitis incidence requires development of new sterilized connecting systems during PD-bag exchanges to decrease PD-related peritonitis opportunities. Construction of medical support systems to address social problems is required to maintain long-term PD therapy.
authors.affiliation: Division of Nephrology, Renal Replacement Therapy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. masashim1jp@yahoo.co.jp.|Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. masashim1jp@yahoo.co.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Division of Nephrology, Renal Replacement Therapy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.|Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Division of Nephrology, Renal Replacement Therapy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.|Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Division of Nephrology, Renal Replacement Therapy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.|Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Sakata
authors.affiliation: Yokkaichi Municipal Hospital, Yokkaichi, Japan.|Kasugai Municipal Hospital, Kasugai, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Saka
authors.affiliation: Konan Kosei Hospital, Konan, Japan.
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Hiramatsu
authors.affiliation: Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tamai
authors.affiliation: Handa City Hospital, Handa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Mizutani
authors.affiliation: Kasugai Municipal Hospital, Kasugai, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Naruse
authors.affiliation: Ogaki Municipal Hospital, Ogaki, Japan.
authors.forename: Norimi
authors.initials: N
authors.lastname: Ohashi
authors.affiliation: Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Hirotake
authors.initials: H
authors.lastname: Kasuga
authors.affiliation: Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Toyota Kosei Hospital, Yoyota, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kurata
authors.affiliation: Tosei General Hospital, Seto, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Kurata
authors.affiliation: Kainan Hospital, Yatomi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Minami Seikyo Hospital, Nagoya, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Kido
authors.affiliation: Minami Seikyo Hospital, Nagoya, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Tsuruta
authors.affiliation: Ogaki Kita Clinic, Ogaki, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Matsuoka
authors.affiliation: Daiyukai Daiichi Hospital, Ichinomiya, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Horie
authors.affiliation: Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000706:statistics & numerical data*; D010538:Peritonitis / Q000209:etiology; D011379:Prognosis; D012042:Registries; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D014807:Vitamin D; D002118:Calcium
keywords: Early withdrawal; Education; Peritoneal dialysis; Peritonitis