fiona brown aarti gulyani stephen mcdonald kylie hurst

ANZDATA Report 2012 Chapter 6

Fiona BrownAarti GulyaniStephen McDonaldKylie Hurst

CHAPTER 6PERITONEAL DIALYSIS2012 Annual Report35th Edition

ANZDATA Registry Annual Report 2012Figure 6.1Proportion (%) Peritoneal Dialysis of allHome Dialysis Patients 2007 - 2011 State20072008200920102011Queensland70%68%66%67%66%New South Wales63%67%66%66%66%Australian Capital Territory60%49%46%40%38%Victoria66%67%66%66%67%Tasmania87%83%82%78%81%South Australia95%95%93%88%86%Northern Territory67%63%57%59%51%Western Australia89%89%87%83%81%Australia69%70%69%68%68%New Zealand69%70%68%66%64%ANZDATA Registry Annual Report 2012Figure 6.2Continuous Period of Peritoneal Dialysis 1963 - 2011Months 0-=85 years8 (1%)12 (1%)18 (2%)8 (1%)13 (2%)Total897 (100%)997 (100%)892 (100%)751 (100%)820 (100%)Patients Dialysing00-14 years34 (2%)28 (1%)32 (1%)29 (1%)24 (1%)15-24 years25 (1%)47 (2%)52 (2%)39 (2%)44 (2%)25-34 years76 (4%)84 (4%)97 (4%)90 (4%)96 (5%)35-44 years199 (9%)183 (8%)171 (8%)180 (9%)187 (9%)45-54 years339 (16%)371 (17%)338 (15%)301 (14%)304 (15%)55-64 years480 (22%)507 (23%)480 (22%)458 (22%)453 (22%)65-74 years549 (26%)553 (25%)579 (26%)557 (27%)515 (25%)75-84 years403 (19%)422 (19%)398 (18%)376 (18%)396 (19%)>=85 years32 (1%)47 (2%)53 (2%)52 (2%)50 (2%)Total2137 (100%)2242 (100%)2200 (100%)2082 (100%)2069 (100%)Primary Renal Disease *Glomerulonephritis231 (26%)260 (26%)252 (28%)199 (26%)220 (27%)Analgesic Nephropathy17 (2%)28 (3%)13 (1%)14 (2%)9 (1%)Hypertension131 (15%)118 (12%)148 (17%)96 (13%)112 (14%)Polycystic Disease50 (6%)67 (7%)54 (6%)53 (7%)45 (5%)Reflux Nephropathy29 (3%)40 (4%)39 (4%)22 (3%)23 (3%)Diabetic Nephropathy285 (32%)328 (33%)266 (30%)247 (33%)271 (33%)Miscellaneous96 (11%)80 (8%)81 (9%)82 (11%)89 (11%)Uncertain58 (6%)76 (8%)39 (4%)38 (5%)51 (6%)Total897 (100%)997 (100%)892 (100%)751 (100%)820 (100%) * New patients receiving first peritoneal dialysis treatmentANZDATA Registry Annual Report 2012Figure 6.9

ANZDATA Registry Annual Report 2012Figure 6.10




ANZDATA Registry Annual Report 2012

Figure 6.14ANZDATA Registry Annual Report 2012Figure 6.15


ANZDATA Registry Annual Report 2012Figure 6.17 New ZealandStock and Flow of Peritoneal Dialysis by Age Groups 2007 - 2011 Age Groups20072008200920102011New Patients *00-14 years5 (2%)10 (4%)3 (1%)3 (1%)5 (2%)15-24 years5 (2%)13 (5%)4 (1%)8 (3%)4 (2%)25-34 years18 (7%)11 (4%)10 (4%)9 (3%)13 (5%)35-44 years21 (9%)21 (8%)31 (11%)22 (8%)21 (9%)45-54 years43 (18%)55 (20%)59 (21%)43 (16%)37 (15%)55-64 years73 (30%)78 (28%)62 (22%)88 (32%)74 (31%)65-74 years55 (23%)69 (25%)86 (30%)70 (25%)66 (28%)75-84 years18 (7%)17 (6%)27 (10%)32 (12%)18 (8%)>=85 years3 (1%)1 (0%)1 (0%)Total241 (100%)274 (100%)283 (100%)275 (100%)239 (100%)Patients Dialysing00-14 years8 (1%)13 (2%)10 (1%)7 (1%)9 (1%)15-24 years23 (3%)28 (4%)27 (3%)22 (3%)23 (3%)25-34 years36 (5%)30 (4%)33 (4%)30 (4%)26 (3%)35-44 years63 (8%)62 (8%)62 (8%)67 (8%)59 (7%)45-54 years121 (16%)141 (18%)157 (20%)140 (17%)120 (15%)55-64 years195 (26%)209 (27%)212 (27%)235 (28%)236 (30%)65-74 years186 (25%)186 (24%)216 (27%)231 (28%)224 (28%)75-84 years100 (13%)81 (11%)72 (9%)98 (12%)89 (11%)>=85 years14 (2%)13 (2%)10 (1%)3 (0%)4 (1%)Total746 (100%)763 (100%)799 (100%)833 (100%)790 (100%)Primary Renal Disease *Glomerulonephritis55 (23%)65 (24%)57 (20%)65 (24%)55 (23%)Analgesic Nephropathy2 (1%)3 (1%)3 (1%)Hypertension26 (11%)35 (13%)33 (12%)36 (13%)28 (12%)Polycystic Disease11 (5%)12 (4%)18 (6%)7 (3%)10 (4%)Reflux Nephropathy9 (4%)4 (1%)5 (2%)3 (1%)4 (2%)Diabetic Nephropathy105 (44%)115 (42%)127 (45%)134 (49%)103 (43%)Miscellaneous27 (11%)27 (10%)31 (11%)20 (7%)24 (10%)Uncertain8 (3%)14 (5%)12 (4%)7 (3%)12 (5%)Total241 (100%)274 (100%)283 (100%)275 (100%)239 (100%) * New patients receiving first peritoneal dialysis treatmentANZDATA Registry Annual Report 2012Figure 6.18Icodextrin Usage by Modality Type - December 2011Modality TypeAustraliaNew ZealandNoYesNR*TotalNoYesNR*TotalCAPD 512261157883211162439 64.97% 33.12% 1.90%. 73.12% 26.42% 0.46%.APD 70157641281108243351 54.72% 44.96% 0.31%. 30.77% 69.23%.Total 12138371920694293592790 58.63% 40.45% 0.92%. 54.30% 45.44% 0.25%.NR* - Not ReportedANZDATA Registry Annual Report 2012Figure 6.19



ANZDATA Registry Annual Report 2012Figure 6.22Low GDP - Lactate Usage by Modality Type - December 2011Modality TypeAustraliaNew ZealandNoYesNR*TotalNoYesNR*TotalCAPD 756161678843612439 95.94% 2.03% 2.03%. 99.32% 0.23% 0.46%.APD 12433441281339111351 97.03% 2.65% 0.31%. 96.58% 3.13% 0.28%.Total 199950202069775123790 96.62% 2.42% 0.97%. 98.10% 1.52% 0.38%.NR* - Not ReportedANZDATA Registry Annual Report 2012Figure 6.23


ANZDATA Registry Annual Report 2012Figure 6.25Low GDP - Bicarb Usage by Modality Type - December 2011Modality TypeAustraliaNew ZealandNoYesNR*TotalNoYesNR*TotalCAPD 728441678843252439 92.39% 5.58% 2.03%. 98.41% 1.14% 0.46%.APD 1244334128134551351 97.11% 2.58% 0.31%. 98.29% 1.42% 0.28%.Total 197277202069777103790 95.31% 3.72% 0.97%. 98.35% 1.27% 0.38%.NR* - Not ReportedANZDATA Registry Annual Report 2012

Figure 6.26ANZDATA Registry Annual Report 2012

Figure 6.27ANZDATA Registry Annual Report 2012Figure 6.28Peritoneal Dialysis at 90 Days Patient Survival 2000-2011, Censored for Transplant % [95% Confidence Interval]Year of StartingNo. ofPatientsSurvival 6 months1 year3 years5 yearsAustralia 2000-2002126798 [97, 99]92 [90, 93]63 [60, 66]42 [39, 45]2003-2005128597 [96, 98]92 [91, 94]69 [66, 71]47 [44, 50]2006-2008166099 [98, 99]94 [93, 95]73 [71, 75]54 [50, 57]2009-2011130398 [97, 99]94 [92, 95]--New Zealand 2000-200245598 [96, 99]91 [88, 93]62 [57, 67]40 [35, 44]2003-200543598 [96, 99]91 [87, 93]63 [58, 68]41 [36, 46]2006-200841298 [96, 99]94 [91, 96]77 [72, 81]50 [43, 56]2009-2011454100 [98, 100]95 [92, 97]--ANZDATA Registry Annual Report 2012Figure 6.29


ANZDATA Registry Annual Report 2012Figure 6.31Peritoneal Dialysis at 90 Days Patient Survival - Diabetic / Non DiabeticCensored for Transplant Commenced 2000 - 2011% [95% Confidence Interval]No. ofPatientsSurvival 6 months1 year3 years5 yearsAustralia Non Diabetic385798 [98, 99]94 [93, 95]73 [71, 74]54 [52, 56]Diabetic165897 [96, 98]91 [89, 92]62 [59, 64]36 [33, 39]New Zealand Non Diabetic103398 [97, 99]94 [92, 95]71 [67, 74]51 [47, 55]Diabetic72399 [98, 99]91 [89, 93]63 [59, 67]34 [30, 39]ANZDATA Registry Annual Report 2012Figure 6.32


ANZDATA Registry Annual Report 2012Figure 6.34Peritoneal Dialysis at 90 Days Patient Survival - By Age GroupCensored for Transplant 2000 - 2011% [95% Confidence Interval]Age GroupsNo. of PatientsSurvival 6 months1 year3 years5 yearsAustralia 0-39 years76699 [99, 100]99 [97, 99]90 [86, 93]80 [74, 85]40-59 years166298 [98, 99]96 [95, 97]81 [79, 83]66 [63, 69]60-74 years206698 [97, 98]92 [90, 93]66 [63, 68]42 [39, 45]>=75 years102196 [95, 97]87 [85, 89]51 [47, 54]27 [24, 30]New Zealand 0-39 years19999 [96, 100]98 [95, 99]89 [81, 94]78 [66, 85]40-59 years58999 [98, 100]95 [93, 97]74 [70, 78]54 [48, 59]60-74 years74598 [97, 99]91 [89, 93]64 [60, 68]37 [32, 41]>=75 years22395 [91, 97]85 [79, 89]49 [42, 56]24 [18, 30]ANZDATA Registry Annual Report 2012Figure 6.35



* PRD = primary renal diseaseANZDATA Registry Annual Report 2012Figure 6.38

* PRD = primary renal diseaseANZDATA Registry Annual Report 2012ANZDATA Registry Annual Report 2012Figure 6.39Peritoneal Dialysis at 90 Days Technique Survival - Diabetic / Non DiabeticCensored for Transplant Commenced 2000- 2011% [95% Confidence Interval]No. ofPatientsSurvival 6 months1 year3 years5 yearsAustralia Non Diabetic385795 [94, 96]85 [83, 86]55 [53, 57]37 [34, 39]Diabetic165894 [93, 95]85 [83, 87]54 [51, 57]36 [32, 40]New Zealand Non Diabetic103396 [95, 97]90 [88, 92]66 [62, 70]46 [41, 51]Diabetic72398 [97, 99]92 [90, 94]67 [63, 71]43 [36, 49]Figure 6.40


ANZDATA Registry Annual Report 2012Figure 6.42Peritoneal Dialysis at 90 Days Technique Survival - By Age GroupCensored for Transplant 2000 - 2011% [95% Confidence Interval]Age GroupsNo. of PatientsSurvival 6 months1 year3 years5 yearsAustralia 0-39 years76694 [92, 96]82 [79, 85]48 [43, 53]28 [22, 35]40-59 years166293 [91, 94]80 [78, 82]41 [38, 44]22 [20, 25]60-74 years206693 [92, 94]80 [78, 81]38 [36, 41]16 [14, 19]>=75 years102191 [90, 93]74 [71, 77]31 [28, 34]10 [8, 12]New Zealand 0-39 years19995 [91, 97]87 [81, 91]51 [41, 60]28 [18, 39]40-59 years58997 [95, 98]88 [85, 90]48 [43, 53]24 [19, 29]60-74 years74596 [94, 97]82 [79, 85]46 [42, 50]17 [13, 20]>=75 years22392 [87, 95]79 [73, 84]36 [29, 43]10 [6, 15]ANZDATA Registry Annual Report 2012Figure 6.43


ANZDATA Registry Annual Report 2012Figure 6.45Causes of Technique Failure 1-Jan-2010 to 31-Dec-2011Excluding Death, Transplantation, Recovery of Renal FunctionCauses of Technique FailureAustraliaNew ZealandRecurrent/persistent peritonitis13880Acute peritonitis23050Tunnel/exit site infection387Total Infective Causes406 (21%)137 (22%)Inadequate solute clearance23186Inadequate fluid ultrafiltration10453Excessive fluid ultrafiltration53Total Dialysis Failure340 (17%)142 (23%)Dialysate leak4630Hydrothorax2Scrotal oedema163Catheter block4013Catheter fell out52Hernia5522Abdominal pain182Abdominal surgery3913Other surgery294Haemoperitoneum1Sclerosing peritonitis12Miscellaneous8818Multiple adhesions55Total Technical Failure344 (18%)115 (19%)Unable to manage self care9730Patient preference750186Transfer outside Australia/NZ63Total Social Reasons853 (44%)219 (36%)ANZDATA Registry Annual Report 2012Figure 6.46First PD Treatment to First Episode of PeritonitisRelated to Age at Entry 01-Jan-2007 to 31-Dec-2011SurvivalAge Groups All00-1415-3435-5455-6465-74>=75Australia (n=102)(n=352)(n=1179)(n=959)(n=1015)(n=750)(n=4357)3 months80 [71,87]87 [83,90]86 [84,88]88 [86,90]88 [86,90]86 [84,89]87 [86,88]6 months70 [59,78]80 [76,84]79 [77,82]80 [77,82]81 [79,84]79 [76,82]80 [78,81]9 months59 [48,69]73 [67,78]73 [70,75]71 [68,74]75 [72,78]71 [68,75]72 [71,74]1 year 54 [42,65]69 [63,75]67 [63,70]66 [62,69]69 [66,72]64 [60,68]66 [65,68]2 years31 [16,47]52 [45,59]47 [43,51]46 [41,50]49 [45,53]46 [41,51]47 [45,49]3 years12 [1,37]41 [32,50]32 [27,36]35 [30,40]32 [27,37]38 [33,43]34 [32,36]New Zealand(n=26)(n=95)(n=353)(n=375)(n=346)(n=117)(n=1312)3 months76 [54,88]87 [78,93]90 [86,92]83 [79,87]86 [82,89]85 [77,91]86 [84,88]6 months50 [29,68]79 [68,87]79 [74,83]74 [69,78]77 [72,81]79 [70,86]76 [74,79]9 months44 [23,63]67 [55,76]70 [64,74]67 [62,72]68 [63,73]69 [59,77]68 [65,70]1 year 35 [14,57]63 [51,73]63 [57,68]60 [54,65]61 [55,67]62 [51,71]61 [58,64]2 years35 [14,57]40 [26,54]45 [38,51]43 [36,49]43 [37,50]43 [31,55]43 [40,46]3 years-19 [7,35]31 [23,39]37 [30,44]31 [24,39]27 [13,42]31 [27,35]% Survival [95% Confidence Interval]ANZDATA Registry Annual Report 2012Figure 6.47



Figure 6.49


ANZDATA Registry Annual Report 2012Figure 6.51First Home APD Treatment to First Episode of PeritonitisRelated to Age at Entry 01-Jan-2007 to 31-Dec-2011SurvivalAge Groups All00-1415-3435-5455-6465-74>=75Australia (n=88)(n=267)(n=761)(n=575)(n=596)(n=415)(n=2702)3 months84 [74, 91]90 [85, 93]88 [85, 90]91 [88, 93]90 [87, 92]90 [87, 93]89 [88, 90]6 months74 [63, 82]84 [79, 88]80 [77, 83]83 [79, 86]82 [78, 85]83 [79, 87]82 [80, 83]9 months63 [51, 74]77 [70, 82]73 [70, 77]76 [72, 80]75 [71, 79]74 [69, 78]74 [73, 76]1 year 59 [46, 70]72 [65, 78]67 [63, 71]69 [64, 73]71 [66, 75]69 [63, 74]69 [67, 71]2 years34 [17, 51]53 [44, 62]50 [45, 55]51 [46, 56]52 [46, 57]48 [42, 55]50 [48, 53]3 years14 [1, 40]40 [30, 51]32 [26, 38]39 [32, 46]35 [29, 42]45 [38, 52]36 [33, 40]New Zealand(n=24)(n=67)(n=175)(n=144)(n=109)(n=43)(n=562)3 months83 [60, 93]82 [70, 90]87 [81, 91]91 [85, 95]86 [77, 91]90 [75, 96]87 [84, 90]6 months54 [32, 72]79 [66, 87]79 [72, 84]82 [74, 88]70 [59, 78]78 [61, 89]77 [73, 80]9 months48 [26, 68]59 [45, 71]70 [62, 77]74 [64, 81]61 [50, 70]63 [44, 76]66 [62, 70]1 year 39 [16, 61]57 [43, 69]61 [52, 69]62 [52, 70]52 [41, 63]56 [38, 71]58 [53, 62]2 years39 [16, 61]29 [15, 45]46 [36, 56]50 [39, 60]36 [23, 48]-40 [35, 46]3 years-18 [6, 36]32 [20, 45]36 [23, 49]21 [8, 38]-27 [20, 34]% Survival [95% Confidence Interval]ANZDATA Registry Annual Report 2012

Figure 6.52ANZDATA Registry Annual Report 2012Figure 6.53Number of Peritonitis EpisodesYearFreq.PercentCum.20032502.592.5920041,19612.414.9920051,07211.1126.120061,11611.5737.6720071,2541350.6720081,36914.1964.8620091,34513.9478.820101,13811.890.620119079.4100Total9,647100ANZDATA Registry Annual Report 2012Figure 6.54






ANZDATA Registry Annual Report 2012Among episodes of peritonitis treated during 2011, the proportion of those who received vancomycin inthe initial or second antibiotic regimen.Figure 6.60


























fiona brown aarti gulyani stephen mcdonald kylie hurst

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