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Impact of Incremental Risk Factors on Peritoneal Dialysis Patient Survival: Proposal of a Simplified Clinical Mortality Risk Score

Background/Aim: Peritoneal dialysis (PD) patient survival is influenced by many factors and there is no consensus on the relative importance of these predictors, independently or combined. This study was designed to evaluate how these independent factors, alone or in various combinations, may influence PD patient survival. Methods: A peritoneal equilibration test, subjective global assessment (SGA), and comorbid diseases (CMD) were assessed. Results: On multivariate analysis, age (>60 years), CMD, malnutrition, and low RRF (≤2 ml/min) were independent predictors of mortality. Three-year patient survival was 100, 95, 75, 49, and 0%, and the risk ratio for mortality was 1.0, 6.6, 21.9, and 85.9 in patients with none, one, two, three, and four of these risk factors, respectively. Conclusions: The combination of independent predictors of mortality in PD patients leads to a markedly increasing risk for mortality. Evaluation of a single risk factor underestimates the true impact of risk factors.