Reasons and outcome of patients transferred from hemodialysis to peritoneal dialysis in a Sub-Saharan environment: example of the Aristide Le Dantec University Hospital in Dakar

Abstract

Introduction:

Few data are available in the literature regarding patients with end-stage renal disease initially treated with chronic hemodialysis and then transferred to peritoneal dialysis. The aims of this study were to evaluate the reasons for transferring patients from chronic hemodialysis to peritoneal dialysis and monitor their outcome in peritoneal dialysis.

Patients and Methods:

A retrospective, descriptive and analytical study over 17 years, conducted at the peritoneal dialysis unit of the Aristide Le Dantec University Hospital. Included were patients over 18 years of age in chronic hemodialysis for at least 3 months, then transferred to peritoneal dialysis. Data were collected from medical records.  

Results: Twenty-six patients were collected. The average age at initiation of peritoneal dialysis was 52.19±15.37 years. The sex ratio was 0.62. The main causal nephropathy was hypertensive nephropathy (46.2%). The reasons for transfer were personal choice (50%), vascular access problems (42.3%), hemodynamic intolerance (3.8%) and cardiovascular instability (3.8%). Concerning the outcome: 52.2% of patients died, 43.5% returned to hemodialysis and 4.3% had a kidney transplant. The average survival was 503,000±108,343 days. Female gender and transient vascular access were risk factors for mortality of transferred patients (OR=0.043 95% CI [1.085; 148.243] p=0.045) and (OR=0.047 95% CI [1.035; 112.840] p=0.048) respectively.

Conclusion: The transfer from hemodialysis to peritoneal dialysis must be anticipated in our context to reduce the morbidity and mortality of our patients on chronic dialysis.