Risk factors for the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis patients

PLoS One. 2014 Sep 15;9(9):e107485. doi: 10.1371/journal.pone.0107485. eCollection 2014.

Abstract

Background: The first episode of peritonitis affects survival of the peritoneal membrane as a medium for dialysis as well as survival of patients. The aim of this study is to investigate risk factors associated with the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis (CAPD) patients.

Methods: This is a single-center, retrospective, cohort study. All incident CAPD patients from 1 January 2006 to 31 December 2010 were recruited, and followed up until their first episode of peritonitis or 31 December, 2012. Baseline demographic, socioeconomic, clinical and laboratory data were collected. Cox proportional model was used to determine the factors associated with the first episode of peritonitis.

Results: In a cumulative 30756.5 patient-months follow-up (the median vintage 26.1 months) of 1117 CAPD patients, 309(27.7%) patients presented the first episodes of peritonitis. The cumulative peritonitis-free survival was 86.2%, 78.1%, 71.4% and 57.8% at 1, 2, 3 and 5 year, respectively. The multivariate analysis showed that factors associated with risk for the first episode of peritonitis were elderly patients (>65 years) [hazard ratio (HR) = 1.427, 95% confidence interval (CI) = 1.051 to 1.938, P = 0.023], male(HR = 1.315, 95% CI = 1.028 to 1.684, P = 0.030), lower education level (HR = 1.446, 95% CI: 1.127 to 1.855, P = 0.004) and albumin <38g/L (HR = 1.425, 95% CI: 1.112 to 1.825, P = 0.005).

Conclusions: Older age, male, lower educational level and hypoalbuminemia at the commencement of PD were the risk factors associated with the first episode of peritonitis in Southern Chinese CAPD patients.

Publication types

  • Clinical Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / pathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritoneum / pathology*
  • Peritonitis / epidemiology
  • Peritonitis / pathology
  • Peritonitis / therapy*
  • Proportional Hazards Models
  • Risk Factors

Grants and funding

This study is supported by the U.S Baxter’s Renal Discoveries Extramural Grant Program, Key Clinical Program of the Ministry of Health of China (2010439); the National Basic Research Program of China (Grant No 2011CB504000) and the National Key Technology R&D Program (No. 2011BAI10B08).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.