title: Patient-Doctor Contact Interval and Clinical Outcomes in Continuous Ambulatory Peritoneal Dialysis Patients.
abstract: BACKGROUND
  The optimal patient-doctor contact (PDC) interval remains unknown in peritoneal dialysis (PD) patients. The aim was to investigate the association between PDC interval and clinical outcomes in continuous ambulatory PD (CAPD) patients.
  
  
  METHODS
  In this retrospective cohort study, CAPD patients who resided in Guangzhou city between January 2006 and December 2012 were included. According to receiver operating characteristic curve analysis, all patients were classified as high (PDC interval ≤2 months) and low (PDC interval >2 months) PDC frequency groups. Biochemical data, clinical events, and clinical outcomes during the follow-up period were compared.
  
  
  RESULTS
  Of 433 CAPD patients, the mean age was 51.3 ± 15.7 years, 54.3% of patients were male, and 29.1% with diabetes. The median vintage of PD was 45.8 (26.3-69.1) months. Patients with high PDC frequency (n = 233) had better patient-survival rates (99.6, 87.7, and 76.5% vs. 92.7, 76.5, and 58.7% at 1, 3, and 5 years; p < 0.001), lower peritonitis rate (0.17 vs. 0.23 episodes per patient-year; p < 0.001), and hospitalization rate (0.49 vs. 0.67 episodes per patient-year; p < 0.001) than those in the low PDC frequency group (n = 200). After adjustment for confounders, PDC interval of no more than 2 months was independently associated with better patient survival (hazard ratio 0.60, 95% CI 0.42-0.86, p = 0.006).
  
  
  CONCLUSIONS
  A PDC interval of 2 months or less was associated with better clinical outcomes in CAPD patients. This indicates that a shorter PDC interval should be encouraged for them to achieve better clinical outcomes.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University and Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Yi
authors.forename: Qunying
authors.initials: Q
authors.lastname: Guo
authors.forename: Jianxiong
authors.initials: J
authors.lastname: Lin
authors.forename: Jianying
authors.initials: J
authors.lastname: Li
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
authors.forename: Xiao
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000523:psychology; D010538:Peritonitis / Q000139:chemically induced / Q000453:epidemiology*; D010817:Physician-Patient Relations; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors