Factors affecting peritoneal dialysis continuity: single-center experience

Mesudiye Bulut; Buse Hacıoğlu; Fatih Gökhan Akbay; Bülent Erdoğan; Sara İleri; Yusuf Oğuz; Hadim Akoğlu

Factors affecting peritoneal dialysis continuity: single-center experience

Abstract

Aims: Peritoneal dialysis (PD) is an effective renal replacement therapy; however, technique failure and treatment discontinuation remain major challenges. Identifying modifiable clinical and biological risk factors is essential to improve PD continuity. Methods: This single-center retrospective cohort study included 96 adult PD patients followed between January 2018 and September 2025. Patients were classified into PD continuation and dropout groups, with dropout defined as transition to hemodialysis, mortality, or permanent cessation of PD. Inflammatory indices including systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and C-reactive protein-albumin-lymphocyte (CALLY) index were calculated. Comparative analyses were performed, and multivariate logistic regression was used to identify independent predictors. Results: Among 96 patients, 54 continued PD and 31 discontinued treatment. Peritonitis was significantly more frequent in the dropout group, particularly ≥2 episodes (p=0.014). Inflammatory markers were markedly elevated in the dropout group (CRP, SII, SIRI; p<0.001), whereas the CALLY index was significantly lower (p<0.001). Multivariate analysis identified recurrent peritonitis, elevated SII and SIRI, and decreased CALLY index as independent predictors of PD discontinuation. Conclusion: PD discontinuation is strongly associated with recurrent peritonitis and increased inflammatory burden. Composite indices such as SII, SIRI, and CALLY may serve as practical tools for risk stratification and improving long-term PD outcomes.

Keywords

Supporting Institution

none

Project Number

(Date: 14.11.2024, Decision No: 2024/70).

Ethical Statement

The study was approved by the XX University Clinical Research Ethics Committee (Date: 14.11.2024, Decision No: 2024/70).

Thanks

The authors acknowledge the use of artificial intelligence–based language editing tools for linguistic refinement

References

International Society of Nephrology. Global kidney health atlas. Brussels: ISN; 2019.
Abe M, Hamano T, Hoshino J, et al. Predictors of outcomes in patients on peritoneal dialysis: a 2-year nationwide cohort study. Sci Rep. 2019; 9:3967. doi:10.1038/s41598-019-40692-6
Jager KJ, Merkus MP, Dekker FW, et al. Mortality and technique failure in patients starting chronic peritoneal dialysis: results of the NECOSAD study. Kidney Int. 1999;55:1476-1485. doi:10.1046/j.1523-1755.1999.00353.x
Sipahioglu MH, Aybal A, Unal A, Tokgoz B, Oymak O, Utas C. Patient and technique survival and factors affecting mortality on peritoneal dialysis in Turkey: 12 years’ experience in a single center. Perit Dial Int. 2008;28:238-245.
Dong K, Zheng Y, Wang Y, Guo Q. Predictive role of neutrophil percentage-to-albumin ratio, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index for mortality in patients with MASLD. Sci Rep. 2024;14:30403. doi:10.1038/s41598-024-80801-8
Eren N, Eryilmaz Y, Ergul M, et al. Periton diyalizi hastalarının periton diyalizinden ayrılma nedenleri: tek merkez deneyimi. Sakarya Med J. 2020;10:629-635. doi:10.31832/smj.785001
Chaudhary K. Peritoneal dialysis drop-out: causes and prevention strategies. Int J Nephrol. 2011;2011:434608. doi:10.4061/2011/434608
Kolesnyk I, Dekker FW, Boeschoten EW, Krediet RT. Time-dependent reasons for peritoneal dialysis technique failure and mortality. Perit Dial Int. 2010;30:170-177. doi:10.3747/pdi.2008.00277

Jager KJ, Kramer A, Chesnaye NC, et al. High mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe. Kidney Int. 2020;98:1540-1548. doi:10.1016/j.kint.2020.09.006
Nerbass FB, Vodianitskaia RM, Ferreira HC, Sevignani G, Vieira MA, Calice-Silva V. Increase in peritoneal dialysis-related hospitalization rates after telemedicine implementation during the COVID-19 pandemic. Nefrologia. 2023;43:239-244. doi:10.1016/j.nefroe.2022.11.023
Wu HY, Hung KY, Hu FC, et al. Risk factors for high dialysate glucose use in peritoneal dialysis patients: a retrospective 5-year cohort study. Perit Dial Int. 2010;30:448-455. doi:10.3747/pdi.2009.00063
Li PK, Chow KM, Cho Y, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int. 2022;42(2):110-153. doi:10.1177/08968608221080586
Luo Q, Xia X, Lin Z, et al. Very early withdrawal from treatment in patients starting peritoneal dialysis. Ren Fail. 2018;40:8-14. doi:10.1080/ 0886022X.2017.1419965
Bonenkamp AA, van Eck van der Sluijs A, Dekker FW, et al. Modifiable causes and patient-specific risk factors for peritoneal dialysis outcomes. Perit Dial Int. 2023;43:73-83. doi:10.1177/08968608221077461
Ambruso SL, Teitelbaum I. Prevention of peritoneal dialysis drop-out. Adv Perit Dial. 2018;34:19-23.
Sarıdaş A, Çetinkaya R. The prognostic value of the CALLY index in sepsis: a composite biomarker reflecting inflammation, nutrition, and immunity. Diagnostics. 2025;15:1026. doi:10.3390/diagnostics15081026
Mancinetti F, Guazzarini AG, Gaspari M, et al. Integrating nutrition, inflammation, and immunity: the CALLY index as a novel prognostic biomarker in acute geriatric care. Nutrients. 2025;17:3192. doi:10.3390/nu1720319

Details

Primary Language

English

Subjects

Nefroloji

Journal Section

Research Article

Authors

Mesudiye Bulut ^*
0009-0003-2598-6785
Türkiye

Buse Hacıoğlu This is me
0000-0003-3838-7610
Türkiye

Fatih Gökhan Akbay
0000-0002-4263-1391
Türkiye

Bülent Erdoğan
0000-0002-9848-2700
Türkiye

Sara İleri
0000-0002-9618-7521
Türkiye

Yusuf Oğuz
0009-0009-2100-5816
Türkiye

Hadim Akoğlu This is me
0000-0001-6308-5150
Türkiye

Publication Date

May 22, 2026

Submission Date

February 23, 2026

Acceptance Date

April 25, 2026

Published in Issue

Year 2026 Volume: 8 Number: 3

IZ

https://izlik.org/JA26HM56JX

Cite

RIS / Bibtex

APA

Bulut, M., Hacıoğlu, B., Akbay, F. G., Erdoğan, B., İleri, S., Oğuz, Y., & Akoğlu, H. (2026). Factors affecting peritoneal dialysis continuity: single-center experience. Anatolian Current Medical Journal, 8(3), 498-503. https://izlik.org/JA26HM56JX

AMA

1.Bulut M, Hacıoğlu B, Akbay FG, et al. Factors affecting peritoneal dialysis continuity: single-center experience. Anatolian Curr Med J / ACMJ / acmj. 2026;8(3):498-503. https://izlik.org/JA26HM56JX

Chicago

Bulut, Mesudiye, Buse Hacıoğlu, Fatih Gökhan Akbay, et al. 2026. “Factors Affecting Peritoneal Dialysis Continuity: Single-Center Experience”. Anatolian Current Medical Journal 8 (3): 498-503. https://izlik.org/JA26HM56JX.

EndNote

Bulut M, Hacıoğlu B, Akbay FG, Erdoğan B, İleri S, Oğuz Y, Akoğlu H (May 1, 2026) Factors affecting peritoneal dialysis continuity: single-center experience. Anatolian Current Medical Journal 8 3 498–503.

IEEE

[1]M. Bulut et al., “Factors affecting peritoneal dialysis continuity: single-center experience”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 3, pp. 498–503, May 2026, [Online]. Available: https://izlik.org/JA26HM56JX

ISNAD

Bulut, Mesudiye - Hacıoğlu, Buse - Akbay, Fatih Gökhan - Erdoğan, Bülent - İleri, Sara - Oğuz, Yusuf - Akoğlu, Hadim. “Factors Affecting Peritoneal Dialysis Continuity: Single-Center Experience”. Anatolian Current Medical Journal 8/3 (May 1, 2026): 498-503. https://izlik.org/JA26HM56JX.

JAMA

1.Bulut M, Hacıoğlu B, Akbay FG, Erdoğan B, İleri S, Oğuz Y, Akoğlu H. Factors affecting peritoneal dialysis continuity: single-center experience. Anatolian Curr Med J / ACMJ / acmj. 2026;8:498–503.

MLA

Bulut, Mesudiye, et al. “Factors Affecting Peritoneal Dialysis Continuity: Single-Center Experience”. Anatolian Current Medical Journal, vol. 8, no. 3, May 2026, pp. 498-03, https://izlik.org/JA26HM56JX.

Vancouver

1.Mesudiye Bulut, Buse Hacıoğlu, Fatih Gökhan Akbay, Bülent Erdoğan, Sara İleri, Yusuf Oğuz, Hadim Akoğlu. Factors affecting peritoneal dialysis continuity: single-center experience. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 May 1;8(3):498-503. Available from: https://izlik.org/JA26HM56JX