Long-Term Survival of Peritoneal Dialysis in Children: A Cohort Study

Background: There is little information about the survival rate of pediatric peritoneal dialysis (PD) patients and its risk factors. Therefore, the aim of the present study was to assess survival rate and its risk factors in Iranian children undergoing PD. Materials and Methods: Demographic and laboratory data of 407 Iranian children (up to 19 years old) undergoing PD, from 20 centers in Iran were included. The outcome of interest in our study was survival rate and determination of its risk factors in PD children. The joint models of longitudinal and time-to-event data analysis was used. Results: The median duration of follow-up was 537 (interquartile range: 146 to 1,177) days. Finally, 72 (17.7%) patients died during a period of 23 years. Our results showed that one-year survival rate of PD patients was 93.6% and five-year survival rate was 76.9%. In addition, the most important risk factors for the PD all-cause mortality were age (HR=0.9301; 95% CI: 0.9031 to 0.9587), serum creatinine (HR=0.8907; 95% CI: 0.8138 to 0.9750), platelet count (HR=0.9999; 95% CI: 0.99995 to 0.99999), aspartate aminotransferase level (HR=1.0001; 95% CI: 0.9999, 1.0002), alkaline phosphatase (HR=0.9989; 95% CI: 0.9982 to 0.9997), renal solute clearance rate (HR=0.9839; 95% CI: 0.9700 to 0.9981), and normalized protein catabolic rate (HR=0.4031; 95% CI: 0.1879, 0.8648). Conclusion: The survival rate of Iranian pediatric PD patients is similar to other countries. It is suggested that laboratory assessment be continually