Canada-USA (CANUSA) multicentre study of peritoneal dialysis adequacy: description of the study population and preliminary results. CANUSA Peritoneal Dialysis Study Group.

The adequacy of peritoneal dialysis should be defined by clinical outcomes. Studies using multivariate techniques to evaluate the effect of demographic and clinical risk factors on these clinical outcomes showed worse patient survival for age > 60 years, diabetes mellitus, history of cardiovascular disease, black race and prior ESRD therapy. The single study reporting a multivariate analysis of urea kinetics and these baseline prognostic factors on clinical outcome showed serum albumin to be the most powerful predictor of survival. A multicentre study (10 Canadian and 4 US Centres) has enrolled 374 consecutive new peritoneal dialysis patients. The target enrollment is 600 patients. Among these 374 patients are 217 males (58%), 71 patients age > 70 (19%), 106 with diabetic renal disease (28%), 95 with a history of cardiovascular disease (25%) and 60 with serum albumin values < 30 Gm/L (16%). There are 307 white patients (82%) and 26 black patients (7%). The 9 month probabilities were: for patient survival, 96%; for technique survival, 93%; peritonitis-free survival, 68%; exit site infection-free survival, 71%. Final statistical analysis will use multivariate techniques to evaluate the relationships among baseline prognostic factors, nutritional status and clinical outcomes.