Peritoneal dialysis outcomes in patients with nephrotic syndrome: a propensity score-matched cohort study

• Published in: Renal failure 2020-01, Vol.42 (1), p.684-692
• Main Authors: Zhou, Si-Jia, Cong, Ya-Kun, Han, Qing-Feng, Tang, Wen, Wang, Tao
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cause of Death; China; Clinical Study; Cohort analysis; Diabetes mellitus; End-stage renal disease; Female; Humans; Kidney diseases; Kidney Failure, Chronic - etiology; Male; Middle Aged; Mortality; Nephrotic syndrome; Nephrotic Syndrome - mortality; Nephrotic Syndrome - therapy; outcomes; Peritoneal Dialysis; Peritoneum; Propensity Score; Retrospective Studies; Risk Factors; Survival; Survival Analysis; Treatment Failure
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/0886022X.2020.1792316

It is unclear whether patients with end-stage renal disease (ESRD) and nephrotic syndrome (NS) can be treated with peritoneal dialysis (PD). To investigate the outcomes of PD treatment in ESRD patients with or without NS. In this retrospective cohort study, all incident patients with ESRD and NS who started PD from 1 February 2006 to 31 December 2017, were matched with patients without NS using propensity scores based on age, sex, diabetes mellitus status, and serum albumin. Fifty-three patients in the NS PD group and 53 matched controls were included. The median survival of the NS PD group was comparable to that of the non-NS PD group. An interaction effect was observed between survival time and baseline NS status. Thus, patients' outcomes within and after 1.5 years were analyzed separately. Both mortality (log-rank test, p= .235) and technique failure (log-rank test, p= .543) rates within 1.5 years in patients with NS were comparable to those of the non-NS group. After 1.5 years, however, the NS status at baseline was associated with lower all-cause mortality (p= .020) and lower technique failure (p= .008) rates in PD patients compared with the non-NS group. The multivariable Cox regression analysis showed that compared with the patients in the non-NS PD group, PD patients with NS had both significantly lower all-cause mortality and lower technique failure rate after adjusting for other factors. Our study indicates that PD may be considered as a long-term renal replacement therapy for patients with ESRD and baseline NS.