title: Duration of Hemodialysis Following Peritoneal Dialysis Cessation in Australia and New Zealand: Proposal for a Standardized Definition of Technique Failure.
abstract: ♦ BACKGROUND: Although technique failure is a key outcome in peritoneal dialysis (PD), there is currently no agreement on a uniform definition. We explored different definitions of PD technique failure using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. ♦ METHODS: We included 16,612 incident PD patients in Australia and New Zealand from January 1998 to December 2012. Different definitions of technique failure were applied according to the minimum number of days (30, 60, 90, 180, or 365) the patient received hemodialysis after cessation of PD. ♦ RESULTS: Median technique survival varied from 2.0 years with the 30-day definition to 2.4 years with the 365-day definition. For all definitions, the most common causes of technique failure were death, followed by infectious complications. The likelihood of a patient returning to PD within 12 months of technique failure was highest in the 30-day definition (24%), and was very small when using the 180- and 365-day definitions (3% and 0.8%, respectively). Patients whose technique failed due to mechanical reasons were the most likely to return to PD (46% within 12 months using the 30-day definition). ♦ CONCLUSIONS: Both 30- and 180-day definitions have clinical relevance but offer different perspectives with very different prognostic implications for further PD. Therefore, we propose that PD technique failure be defined by a composite endpoint of death or transfer to hemodialysis using both 30-day and 180-day definitions.
authors.affiliation: Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia plan1744@uni.sydney.edu.au.|Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia.|Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Lan
authors.affiliation: Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia.|Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia.|Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Clayton
authors.affiliation: Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia.|Translational Research Institute, Brisbane, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
authors.affiliation: Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia.|Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia.|School of Medicine, Faculty of Health Sciences, University of Adelaide.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: McDonald
authors.affiliation: Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Monique
authors.initials: M
authors.lastname: Borlace
authors.affiliation: Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Sunil V
authors.initials: SV
authors.lastname: Badve
authors.affiliation: Departments of Renal Medicine, Nepean and Westmead Hospitals, Sydney, Australia.|Nepean Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Kamal
authors.initials: K
authors.lastname: Sud
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Boudville
mesh_terms: D000367:Age Factors; D000368:Aged; D001315:Australia; D004868:Equipment Failure; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D011379:Prognosis; D012042:Registries; D006435:Renal Dialysis / Q000379:methods* / Q000401:mortality; D019233:Retreatment / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D028761:Withholding Treatment
keywords: Hemodialysis; peritoneal dialysis; standardized definition; technique failure