1. ASSOCIATION OF SOCIO-ECONOMIC POSITION WITH TECHNIQUE FAILURE AND MORTALITY IN AUSTRALIAN NON-INDIGENOUS PERITONEAL DIALYSIS PATIENTS
Dr Samuel Chan
Nephrology Advanced Trainee
Australian and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia
Princess Alexandra Hospital, Brisbane, Queensland, Australia
The University of Queensland, School of Medicine, Brisbane, Queensland

2. GLOBAL TECHNIQUE SURVIVAL
Jose, Johnson et al Nephrology 16:19-29, 2011

3. IMPETUS FOR STUDY
Socio-economic position may influence technique survival
Socio-economic position is an important public health issue
Changes in models of health care
Changes to resource allocation

4. AIM
To investigate the association between socio-economic position with technique failure and mortality in all non-indigenous peritoneal dialysis patients in Australia

5. METHODOLOGY
All non-indigenous Australian adult patients who commenced PD
01/01/1994 to 31/12/2014 (ANZDATA Registry)
Outcome measures
Technique failure (30-day and 180-day)
Patient survival
Socio-economic position based on Socio-Economic Index for Areas (SEIFA)
Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD)
Index of Relative Socio-Economic Disadvantage (IRSD)
Index of Education and Occupation (IEO)
Index of Economic Resources (IER)

6. PATIENT CHARACTERISTICS
IRSAD
Total Population (n=9766)
Quartile 1 (n=2844)
Quartile 2
(n= 3166)
Quartile 3
(n=1819)
Quartile 4
(n=1937)
P-value
Age (years)
61 ± 15
61 ± 14
60 ± 15
0.04
Gender
Male
5536 (57%)
1553 (55%)
1774 (56%)
1051 (58%)
1158 (60%)
0.003
Racial origin
Caucasian
7982 (82%)
2318 (82%)
2625 (83%)
1515 (83%)
1524 (79%)
Asian
1170 (12%)
314 (11%)
343 (11%)
207 (11%)
306 (16%)
Maori/Pacific Islander
224 (2%)
81 (3%)
77 (2%)
39 (2%)
27 (1%)
Other
390 (4%)
131 (5%)
121 (4%)
58 (3%)
80 (4%)
<0.001
Body Mass Index (kg/m2)
<20
862 (9%)
239 (8%)
271 (9%)
167 (9%)
185 (10%)
20-25
3403 (35%)
930 (33%)
1079 (34%)
656 (36%)
738 (38%)
>25-30
3355 (35%)
981 (35%)
1099 (35%)
628 (35%)
647 (34%)
>30
2091 (22%)
679 (24%)
700 (22%)
359 (20%)
353 (18%)
Co-morbidities
Current smoking status
1038 (11%)
343 (12%)
359 (11%)
151 (8%)
Chronic lung disease
1305 (13%)
436 (15%)
427 (14%)
230 (13%)
212 (11%)
Ischaemic heart disease
3640 (37%)
1127 (40%)
1167 (37%)
675 (37%)
671 (35%)
0.006
Peripheral vascular disease
2407 (25%)
734 (26%)
811 (26%)
437 (24%)
425 (22%)
0.009
Cerebrovascular accident
1101 (12%)
338 (13%)
377 (12%)
188 (11%)
198 (10%)
0.05
Diabetes mellitus
3707 (38%)
1135 (40%)
1221 (39%)
665 (37%)
686 (35%)
0.008

7. TECHNIQUE FAILURE 30 DAYS – IRSAD 30 DAYS - IRSD HR CI Q1 Ref. Q2 0.96 Q3
0.97 Q4
1.00 HR CI Q1
Ref. Q2
1.07 Q3
0.99 Q4
1.04

8. TECHNIQUE FAILURE 30 DAYS – IER 30 DAYS – IEO HR CI Q1 Ref. Q2 1.00 Q3
1.01 Q4
0.98 HR CI Q1
Ref. Q2
0.93 Q3
0.97 Q4
1.00

9. TECHNIQUE FAILURE 180 DAYS – IRSAD 180 DAYS – IRSD HR CI Q1 Ref. Q2
0.96 Q3
0.97 Q4 HR CI Q1
Ref. Q2
1.04 Q3
0.96 Q4
1.00

10. TECHNIQUE FAILURE 180 DAYS – IER 180 DAYS – IEO HR CI Q1 Ref. Q2 0.98 Q3
0.99 Q4
0.96 HR CI Q1
Ref. Q2
0.94 Q3
0.96 Q4
1.01

11. MORTALITY IRSAD IRSD HR CI Q1 Ref. Q2 0.96 0.86-1.06 Q3 0.87 0.77-0.99 HR CI Q1
Ref. Q2
1.02 Q3
0.94 Q4
0.85

12. MORTALITY IER IEO HR CI Q1 Ref. Q2 0.99 0.88-1.10 Q3 0.97 0.86-1.10 Q4
0.89 HR CI Q1
Ref. Q2
0.94 Q3 Q4
0.85

13. CONCLUSIONS
Socio-economic position was not associated with technique failure
Higher socio-economic position was associated with better patient survival
Future studies should examine the relationship between socio-economic position and technique failure in indigenous patients

14. ACKNOWLEDGEMENTS
ANZDATA Registry – Stephen P McDonald and Philip A Clayton
Project supervisors – Prof David W Johnson, A/Prof Carmel M Hawley, Dr Yeoungjee Cho, A/Prof David W Mudge, Dr Ross S Francis
Australian Kidney Trials Network (AKTN) and Elaine Pascoe