Peritoneal Dialysis in Morocco: Nineteen Years of Experience from the First National Center and Evaluation of Technique Survival and Mortality

Abstract

Background and aims: Peritoneal dialysis (PD) remains underused despite being a valid alternative to hemodialysis. This study assessed patients’ clinical profiles, technique survival, and mortality at Morocco’s first PD center. Methods: This retrospective study evaluated 247 patients treated with PD from June 2006 to May 2025, with no exclusions. Required data were obtained from the French-language PD Registry and medical records. Finally, t-tests, ANOVA, chi-square tests, and stepwise backward logistic regression were used for statistical analysis (P<0.05). Results: Overall, 233 (94.3%) patients chose PD as their renal replacement therapy (RRT). The average age was 47.5±17.3 years. In addition, 62.7% were male, and 25.4% had diabetes. The median follow-up period was 4.0 years, with an interquartile range of 2.0–7.0. Technique survival rates at 1, 3, and 5 years were 90%, 55%, and 45%, respectively. In addition, patient survival rates were 88%, 65%, and 50%. The incidence of peritonitis was 0.48 episodes per patient-year and was the primary cause of technique failure (53.6%) and contributed to 11.9% of deaths. Logistic regression demonstrated a technique failure associated with diabetes (P=0.038). Mortality was linked to age>60 (P=0.022), vascular access failure (P=0.013), and assisted PD (P=0.003). Hypoalbuminemia (P=0.281), anemia (P=0.176), and hypophosphatemia (P=0.223) were not significant. Conclusion: PD is a long-term RRT in Morocco. Mortality is linked to advanced age, vascular access failure, and assisted PD. Continued patient education and staff training are vital.