Patient outcomes in a PD First Program in Cape Town, South Africa

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dc.contributor.advisorWearne, Nicolaen_ZA
dc.contributor.authorDavidson, Biancaen_ZA
dc.date.accessioned2018-02-07T09:03:59Z
dc.date.available2018-02-07T09:03:59Z
dc.date.issued2017en_ZA
dc.description.abstractBackground: South Africa [SA] currently performs the most peritoneal dialysis [PD] in Africa. Yet, outcome data is limited. With the collision of epidemics of communicable and non-communicable diseases in Africa the need for chronic dialysis is escalating. PD remains a life-saving modality especially as haemodialysis is limited in the state sector. Methods: We retrospectively analysed all patients undergoing PD at Groote Schuur Hospital from January 2008 until June 2014 and thereafter prospectively until June 2015. Variables included demographics, adequacy, modality, fluid, cardiovascular risk and diabetes. The influences of these variables on peritonitis rate, technique and patient survival were assessed. Results: 230 patients were initiated on PD, 31 were excluded as they were on PD for < 90 days. The mean age was 39.7 +/- 10.4 years [SD], 49.8% were male and 63.8% were mixed ancestry. 9.8 % were diabetic at dialysis initiation. The average length of time on PD was 17 months (IQR 8 - 32). The peritonitis rate was 0.87 events per patient years. One, 2 and 5 year patient and technique survival was 94.4%, 84.3% and 60.2% and 82.5%, 69.0% and 37.4% respectively. Fluid overload (p=0.019) and low haemoglobin (p=0.001) were independent risk factors for poor survival. African race (HR 1.97, 95% CI (1.16 - 3.37) and fluid overload (p= 0.002) were both predictors of technique failure. Conclusions: In our PD-First programme the results are encouraging, despite lack of home visits due to safety, resource limitations and a high disease burden. Technique failure in African race needs further evaluation. Peritoneal dialysis remains a viable, life-saving alternative in an African setting.en_ZA
dc.identifier.apacitationDavidson, B. (2017). <i>Patient outcomes in a PD First Program in Cape Town, South Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension. Retrieved from http://hdl.handle.net/11427/27363en_ZA
dc.identifier.chicagocitationDavidson, Bianca. <i>"Patient outcomes in a PD First Program in Cape Town, South Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension, 2017. http://hdl.handle.net/11427/27363en_ZA
dc.identifier.citationDavidson, B. 2017. Patient outcomes in a PD First Program in Cape Town, South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Davidson, Bianca AB - Background: South Africa [SA] currently performs the most peritoneal dialysis [PD] in Africa. Yet, outcome data is limited. With the collision of epidemics of communicable and non-communicable diseases in Africa the need for chronic dialysis is escalating. PD remains a life-saving modality especially as haemodialysis is limited in the state sector. Methods: We retrospectively analysed all patients undergoing PD at Groote Schuur Hospital from January 2008 until June 2014 and thereafter prospectively until June 2015. Variables included demographics, adequacy, modality, fluid, cardiovascular risk and diabetes. The influences of these variables on peritonitis rate, technique and patient survival were assessed. Results: 230 patients were initiated on PD, 31 were excluded as they were on PD for < 90 days. The mean age was 39.7 +/- 10.4 years [SD], 49.8% were male and 63.8% were mixed ancestry. 9.8 % were diabetic at dialysis initiation. The average length of time on PD was 17 months (IQR 8 - 32). The peritonitis rate was 0.87 events per patient years. One, 2 and 5 year patient and technique survival was 94.4%, 84.3% and 60.2% and 82.5%, 69.0% and 37.4% respectively. Fluid overload (p=0.019) and low haemoglobin (p=0.001) were independent risk factors for poor survival. African race (HR 1.97, 95% CI (1.16 - 3.37) and fluid overload (p= 0.002) were both predictors of technique failure. Conclusions: In our PD-First programme the results are encouraging, despite lack of home visits due to safety, resource limitations and a high disease burden. Technique failure in African race needs further evaluation. Peritoneal dialysis remains a viable, life-saving alternative in an African setting. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Patient outcomes in a PD First Program in Cape Town, South Africa TI - Patient outcomes in a PD First Program in Cape Town, South Africa UR - http://hdl.handle.net/11427/27363 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27363
dc.identifier.vancouvercitationDavidson B. Patient outcomes in a PD First Program in Cape Town, South Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Nephrology and Hypertension, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27363en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Nephrology and Hypertensionen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherNephrologyen_ZA
dc.titlePatient outcomes in a PD First Program in Cape Town, South Africaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhilen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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