Comparison of All-cause Mortality and Technique Failure Between Early-late and Very Late Start Peritoneal Dialysis: A Retrospective Cohort Study

Background: Glomerular filtration rate (GFR) is the gold standard for the detection and monitoring ofchronic kidney disease (CKD). Controversy is remaining in the timing of peritoneal dialysis (PD).Objective: This study compared all-cause mortality and technique failure between early-late and very latestart PD in stage-5 CKD patients.Method: A cohort of 828 stage-5 CKD patients from a tertiary hospital was reviewed and analyzed. Patientswere categorized into groups of early-late or very late start PD according to their estimated-GFRs. Theoutcomes were all-cause mortality and technique failure. Survival analysis was performed.Results: Median time to all-cause mortality was 35 months in early-late group, 40 months in very lategroup, while technique failure was found identical in both groups (25 months). There were no statisticallysignificant association in cox regression models.Conclusion: No clinical benefits were found by starting dialysis based on eGFR at the timing of PD (earlyor very late start PD plan). Asymptomatic patients with stage-5 CKD may be safely managed by very latestart PD plan and patients may benefit from the delayed PD initiation.