1. CHAPTER 12 Peritoneal Dialysis Sunita Bavanandan Lily Mushahar Anita Bhajan Manocha Source: 20 th MDTR Report 2012, NRR

2. Table 12.1.1: Peritoneal dialysis regimes, 1997-2012 PD regime 20032004200520062007 n%n%n%n%n% Standard CAPD119296.1126696.8130393.2139790154785.7 DAPD343392.8453.2674.31156.4 Automated PD/ CCPD50.9120.4503.6885.71448 TOTAL12311001317100139810015521001806100 PD regime 20082009201020112012 n%n%n%n%n% Standard CAPD171782.4184783.5197383.6207979.7232080 DAPD1215.81195.4913.91174.51404.8 Automated PD/ CCPD24511.824611.129612.541415.943915.1 TOTAL20831002212100236010026101002899100 Source: 20 th MDTR Report 2012, NRR

3. Table 12.1.2: PD System, 1997-2012 PD System 20032004200520062007 n%n%n%n%n% Baxter disconnect104888.8114787128692.1142592167593.5 Fresenius disconnect15411.214512.81117.91197.71166.5 Others3000.20050.300 TOTAL12051001292100139710015491001791100 PD System 20082009201020112012 n%n%n%n%n% Baxter disconnect195593.9201392.1212690.7223085.8232580.1 Fresenius disconnect12461737.92189.336714.157819.9 Others40.200101010 TOTAL20831002186100234510025981002904100 Source: 20 th MDTR Report 2012, NRR

4. Table 12.1.3a: CAPD Number of Exchanges per day, 1997-2012 Number of exchanges/ day 20032004200520062007 n%n%n%n%n% 230.56030.23 20.1 3141121.2201.5523.7291.9 4110494.8118595.9123495.1129693.2145695.8 5303.8472.9403.1392.8332.2 TOTAL11511001250100129710013901001520100 Number of exchanges/ day 20082009201020112012 n%n%n%n%n% 230.220.170.410100.4 3472.8794.41256.41135.51396.1 4161194.4167692.3177891.1187491.3206490.2 5462.7593.2422.2653.2753.3 TOTAL17071001816100195210020531002288100 Source: 20 th MDTR Report 2012, NRR

5. Table 12.1.3b: APD dwell volumes per day, 1997-2012 Dwell volumes/ day 20032004200520062007 n%n%n%n%n% 80000947.4612.51110.5 1011004 736.83266.78379 120000315.81020.8109.5 140000000000 160000000011 TOTAL11004 1910048100105100 Dwell volumes/ day 20082009201020112012 n%n%n%n%n% 842.275.11114.593.71812.3 1016492.111987.55673.722290.610874 12105.685.9810.5114.51711.6 140000000000 160021.511.331.232.1 TOTAL17810013610076100245100146100 Source: 20 th MDTR Report 2012, NRR

6. Table 12.2.1: Distribution of delivered Kt/V, PD patients 2003-2012 Year Number of Patients MeanSDMedianLQUQ % patients ≥ 1.7 per week 20037632.10.52.11.82.583 200410382.10.52.11.82.485 200510922.10.52.11.82.483 200612662.10.52.11.82.484 200714122.10.52.11.82.483 200816792.10.521.82.482 200918372.10.521.82.481 201019132.10.521.72.379 201117872.10.521.82.379 201223352.10.521.82.379 Source: 20 th MDTR Report 2012, NRR

7. Figure 12.2.1: Cumulative distribution of delivered Kt/V, PD patients 1997-2012 Source: 20 th MDTR Report 2012, NRR

8. Table 12.2.2: Variation in proportion of patients with Kt/V  1.7 per week among PD centres, 1997-2012 Year Number of centres Min5 th CentileLQMedianUQ 95 th Centile Max 200314007582.58891 20041775 798588100 20051856 75858996 20062066 7882.591.5100 200721256978858993 2008203350.576.5808993.596 200921486376838997100 20102248597379869094 201124616470.578.582.59091 201225535970798795100 Source: 20 th MDTR Report 2012, NRR

9. Figure 12.2.2: Variation in proportion of patients with Kt/V  1.7 per week among PD centres Source: 20 th MDTR Report 2012, NRR

10. Table 12.2.3: Peritoneal transport status by PET D/P creatinine at 4 hours, new PD patients 2004-2012 Source: 20 th MDTR Report 2012, NRR

11. Table 12.2.4: Peritoneal Transport Status (PET) with dialysis vintage Duration (Years) <11-<22-<33-<44-<5 n%n%n%n%n% Low5312491034122410128 Low average19043173361164088377448 High average157351934111239103434731 High47116013281023102013 TOTAL447100475100290100238100153100 Duration (Years) 5-<66-<77-<88-<99-<1010 or more n%n%n%n%n%n% Low669133641213410 Low average51492639214510291032921 High average373526391940195619612048 High111069491313921 TOTAL1051006710047100341003110042100 Source: 20 th MDTR Report 2012, NRR

12. Table 12.3.1(a): Unadjusted technique survival by age (uncensored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

13. Figure 12.3.1(a): Unadjusted technique survival by age (uncensored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

14. Table 12.3.1(b): Unadjusted technique survival by age (censored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

15. Figure 12.3.1(b): Unadjusted technique survival by age (censored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

16. Table 12.3.2(a): Unadjusted technique survival by gender (uncensored for death and transplant), 1997-2012 Gender Interval (months) MaleFemale n% survivalSEn% survivalSE 040141003906100 633959003315900 1227537912755801 2417986011895631 3611814411300491 48741321868381 60468241608311 72305181412241 84183131275191 9611191179141 1086971119121 12037517091 Source: 20 th MDTR Report 2012, NRR

17. Figure 12.3.2(a): Unadjusted technique survival by gender (uncensored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

18. Table 12.3.2(b): Unadjusted technique survival by gender (censored for death and transplant), 1997-2012 Gender Interval (months) MaleFemale n% survivalSEn% survivalSE 040141003906100 633959703315970 1227539302755940 2417988511895871 3611817811300791 48741711868731 60468631608681 72305571412641 84183502275582 96111462179522 10869422119492 1203734370432 Source: 20 th MDTR Report 2012, NRR

19. Figure 12.3.2(b): Unadjusted technique survival by gender (censored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

20. Table 12.3.3(a): Unadjusted technique survival by diabetes status (uncensored for death and transplant), 1997-2012 Diabetes status Interval (month) Non-diabeticDiabetic n% survivalSEn% survivalSE 047291003191100 640359202675881 1233698312139751 2423516811342521 361688561790331 481175451432221 60845371231141 7259830111991 843952316351 962591713331 1081731411520 120101111610 Source: 20 th MDTR Report 2012, NRR

21. Figure 12.3.3(a): Unadjusted technique survival by Diabetes status (uncensored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

22. Table 12.3.3(b): Unadjusted technique survival by diabetes status (censored for death and transplant), 1997-2012 Diabetes status Interval (month) Non- diabetesDiabetic n% survivalSEn% survivalSE 047291003191100 640359702675970 1233699302139930 2423518611342851 361688791790771 481175721432721 60845661231672 72598611119622 8439554163573 9625948133543 10817345215485 1201013826437 Source: 20 th MDTR Report 2012, NRR

23. Figure 12.3.3(b): Unadjusted technique survival by diabetes status (censored for death and transplant), 1997-2012 Source: 20 th MDTR Report 2012, NRR

24. Table 12.3.4: Unadjusted technique survival by Kt/V, 1997-2012 Kt/V Interval (months) <1.71.7-2.0>2.0 n% SurvivalSEn% SurvivalSEn% SurvivalSE 0279610039751008131100 6271398038779807963990 12252894036669507514960 24210484131628716393870 36166371126257615171770 48122859120386513996661 6085847115155413093571 7261638111504712305501 844152917793711629421 963092515032911190351 108202201345231846301 120135181205181481241 Source: 20 th MDTR Report 2012, NRR

25. Figure 12.3.4: Unadjusted technique survival by Kt/V,1997-2012 Source: 20 th MDTR Report 2012, NRR

26. Table 12.3.5:Adjusted hazard ratio for change of modality, 1997- 2012 Source: 20 th MDTR Report 2012, NRR

27. Table 12.3.6: Reasons for drop-out from PD program, 2003-2012 Source: 20 th MDTR Report 2012, NRR

28. Table 12.3.7: Drop-out rate from PD program with time on treatment, 2003-2012 Source: 20 th MDTR Report 2012, NRR

29. Table 12.3.8: Time on PD (1997-2012) Source: 20 th MDTR Report 2012, NRR

30. Table 12.4.1 Variation in peritonitis rate (patient-month/episode) among PD centres, 1997-2012 Year Number of centres Min5 th CentileLQMedianUQ95 th CentileMax 199796613.516.123.230 199890017.723.529.154.9 1999914.3 16.319.32131.5 20001111.7 17.423.230.671.4 20011110.8 19.923.641.460.3 20021112.6 17.932.744.4219.2 20031318.2 21.332.939.6312.1 2004150023.632.936.641.5 20051518 26.335.84358 20062114.818.52737.949.865.297.7 2007231212.931.242.155.366.9106.7 20082512133040.458.7105.5114.6 2009251417.629.538.255.7117.7246.1 20102610.819.328.13652.372.284.9 2011288.91233.84663.5103.9260.1 20122725.534.844.353.873.5170249.1 Source: 20 th MDTR Report 2012, NRR

31. Figure 12.4.1 Variation in peritonitis rate among PD centres, 2012 Source: 20 th MDTR Report 2012, NRR

32. Table 12.4.2: Causative organism in PD peritonitis, 2003-2012 Source: 20 th MDTR Report 2012, NRR

33. Figure12.4.2 Causative organism in PD peritonitis, 2001-2012 Source: 20 th MDTR Report 2012, NRR

34. Figure 12.4.3(a): Outcome of peritonitis by causative organism, 2012 63.49% 20.44% 16.07% ResolvedNot resolved, catheter removed Death Outcome of peritonitis in 2012 Source: 20 th MDTR Report 2012, NRR

35. Table 12.4.3(a): Outcome of peritonitis by causative organism, 1993- 2002 Causative OrganismResolved Not resolved, catheter removed DeathTotal n%n%n%n% (A) Gram Positives Staph. Aureus1506923114420217100 Staph Coagulase Neg.135781162615172100 Streptococcus356659132553100 Others115821163219100 (B) Gram Negatives Pseudomonas36382829323396100 Acinetobacter44611014182572100 Klebsiella30451522 3367100 Enterobacter27541020132650100 E.Coli436134243470100 Others155631193327100 (C) Polymicrobial11251432194344100 (D) Others Fungal5544435452103100 Mycobacterium6276 104522100 Others7543233 13100 (E) No growth55571941213317782100 Source: 20 th MDTR Report 2012, NRR

36. Figure 12.4.3(b): Outcome of peritonitis by causative organism, 1993- 2002 0 20 40 60 80 100 Percent (%) Staph. Aureus Staph Coagulase Neg. Strep Others Pseudomonas Acinetobacter Klebsiella Enterobacter E.Coli Others Polymicrobial Fungal Mycobacterium Others No growth ResolvedNot resolved, catheter removedDeath Source: 20 th MDTR Report 2012, NRR

37. Table 12.4.3(b): Outcome of peritonitis by causative organism, 2003- 2012 Causative Organism Resolved Not resolved, catheter removed DeathTotal n%n%n%n% (A) Gram Positives Staph. Aureus3866792169717575100 Staph Coagulase Neg.358803075913447100 Strep153811372413190100 Others827810 1312105100 (B) Gram Negatives Pseudomonas10235832810937294100 Acinetobacter1075834184524186100 Klebsiella1265740185625222100 Enterobacter51581113263088100 E.Coli2226245139326360100 Others42552128131776100 (C) Polymicrobial1032619154831100 (D) Others Fungal106533110763170100 Mycobacterium27829186428100 Others1086229173822175100 (E) No growth9296816612268201363100 Source: 20 th MDTR Report 2012, NRR

38. Figure 12.4.3(c): Outcome of peritonitis by causative organism, 2003- 2012 Source: 20 th MDTR Report 2012, NRR 0 20 40 60 80 100 Percent (%) Staph. Aureus Staph Coagulase Neg. Strep Others Pseudomonas Acinetobacter Klebsiella Enterobacter E.Coli Others Polymicrobial Fungal Mycobacterium Others No growth ResolvedNot resolved, catheter removedDeath

39. Figure 12.4.3(d): Comparing outcome of peritonitis by causative organism in 1993-2002 vs 2003-2012 Source: 20 th MDTR Report 2012, NRR

40. Table 12.4.4: Risk factors influencing peritonitis rate, 1993-2012 Source: 20 th MDTR Report 2012, NRR