title: Technique failure in Korean incident peritoneal dialysis patients: a national population-based study.
abstract: BACKGROUND
  Technique failure is an important issue for peritoneal dialysis (PD) patients. In this study, we aimed to analyze technique failure rate in detail and to determine the predictors for technique failure in Korea.
  
  
  METHODS
  We identified all patients who had started dialysis between January 1, 2005, and December 31, 2008, in Korea, using the Korean Health Insurance Review and Assessment Service database. A total of 7,614 PD patients were included, and the median follow-up was 24.9 months.
  
  
  RESULTS
  The crude incidence rates of technique failure in PD patients were 54.1 per 1,000 patient-years. The cumulative 1-, 2-, and 3-year technique failure rates of PD patients were 4.9%, 10.3%, and 15.6%, respectively. However, those technique failure rates by Kaplan-Meier analysis were overestimated compared with the values by competing risks analysis, and the differences increased with the follow-up period. In multivariate analyses, diabetes mellitus and Medical Aid as a crude reflection of low socioeconomic status were independent risk factors in both the Cox proportional hazard model and Fine and Gray subdistribution model. In addition, cancer was independently associated with a lower risk of technique failure in the Fine and Gray model.
  
  
  CONCLUSIONS
  Technique failure was a major concern in patients initiating PD in Korea, especially in diabetic patients and Medical Aid beneficiaries. The results of our study offer a basis for risk stratification for technique failure.
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Shina
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
authors.forename: Hyunwook
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Public Health, Graduate School, Korea University, Seoul, Korea.
authors.forename: Kyoung Hoon
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Hoo Jae
authors.initials: HJ
authors.lastname: Hann
authors.affiliation: Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hyeong Sik
authors.initials: HS
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Kyu Bok
authors.initials: KB
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Dong-Ryeol
authors.initials: DR
authors.lastname: Ryu
keywords: Peritoneal dialysis; Risk factors; Technique failure