Hospitalization for congestive heart failure as a risk factor for peritoneal dialysis discontinuation: a retrospective cohort study

Background Identifying patients at risk of peritoneal dialysis (PD) discontinuation is important for maintaining long-term PD therapy. However, the risk factors for PD discontinuation remain unclear. We aimed to identify clinical risk factors associated with PD discontinuation, with particular attention to clinical events occurring during the course of PD therapy, in a single-center cohort in Japan. Methods We retrospectively analyzed 65 adult patients who underwent PD between September 2013 and December 2022. Clinical and laboratory data were collected from electronic medical records. The primary endpoint was PD discontinuation, defined as transition to hemodialysis for ≥ 30 days, kidney transplantation, or death from any cause. The risk factors associated with PD discontinuation were evaluated using the Cox proportional hazards model. Results The median patient age was 64 years (interquartile range [IQR] 53–73 years). During a median follow-up of 41 months (IQR 27–55 months), 46 patients (71%) discontinued PD. The most common cause of PD discontinuation was fluid overload (39%). During follow-up, 16 patients were hospitalized for congestive heart failure (CHF), and 15 (94%) subsequently discontinued PD. In the multivariate analysis, hospitalization for CHF during follow-up was strongly associated with PD discontinuation (hazard ratio 5.96; 95% confidence interval 1.90–18.65). Conclusions Hospitalization for CHF during follow-up was strongly associated with PD discontinuation in adult patients. Therefore, it may represent an important clinical indicator of volume management failure and impending PD discontinuation.