Causes of death in peritoneal dialysis patients with different kidney diseases and comorbidities: a retrospective clinical analysis in a Chinese center.

OBJECTIVES: The objective of the study is to identify and compare the different causes of death among peritoneal dialysis (PD) patients varying in baseline characteristics, including gender, age, primary diseases, and comorbidities and to assess risk factors for first-year death.

METHODS: The clinical data of 179 PD patients who were regularly followed up in our hospital and died between January 2006 and February 2011 were retrospectively reviewed.

RESULTS: Median age at PD catheter implantation was 73 years. The most common primary diseases leading to ESRD were diabetic nephropathy (DN; 26.3 %), chronic glomerulonephritis (CGN; 24.6 %), and hypertensive nephropathy (HN; 21.8 %). The main causes of death in the DN and CGN groups were infections (42.6 %) and cardiocerebrovascular accidents (34.1 %), respectively. Patients with systemic vasculitis (SV) had the highest mortality rate from infection (71.4 %). Cox regression model showed that, compared with patients with CGN, those who had primary disease of DN, renal amyloidosis, multiple myeloma, or vasculitis were at higher risk of first-year death. Cerebrovascular disease, chronic heart failure, and/or lower serum albumin at baseline were also risk factors for first-year death.

CONCLUSIONS: The main causes of death in PD patients with DN and CGN were infections and cardiocerebrovascular accidents, respectively. Risk factors for first-year death included the primary diseases, cerebrovascular diseases, chronic heart failure, and lower serum albumin at baseline.