Risk factors for peritoneal dialysis withdrawal due to peritoneal dialysis-related peritonitis |
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| Institution: | 1. Department of Urology, Kawashima Hospital, 1-39 Kitasakoichiban-cho, Tokushima 770-0011, Japan;2. Department of Kidney Disease, Kawashima Hospital, 1-39 Kitasakoichiban-cho, Tokushima 770-0011, Japan;3. Kamojima-Kawashima Clinic, 396-3 Iioazahukui, Kamojima-cho, Yoshinogawa 776-0033, Japan;1. Department of Nephrology, Manchester University Hospitals, Oxford Road, M13 9WL Manchester, UK;2. Manchester Academy of Health Sciences Centre (MAHSC), Manchester, UK;3. NIHR Devices for Dignity MedTech Co-operative, Sheffield, UK;1. Department of Nephrology, hemodiálisis Hospital de Manises, avenida Generalitat Valenciana 50, 46940 Manises Valencia, Spain;2. Biostatistics unit, Instituto de investigación sanitaria La Fe, Valencia, Spain;1. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia;2. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia;3. Australasian Kidney Trial Network, Diamantina Institute, University of Queensland, Brisbane, Australia;4. Department of Renal Medicine, Singapore General Hospital, Singapore;5. Hôpital Maisonneuve-Rosemont, Université de Montreal, Montreal, Canada;6. Translational Research Institute, Brisbane, Australia;7. Central Northern Adelaide Renal and Transplantation Service; Royal Adelaide Hospital, Adelaide, Australia;8. Department of Nephrology, St George Hospital, Sydney, Australia;9. Department of Renal Medicine, Nepean Hospital, Sydney, Australia;10. Department of Renal Medicine, Westmead Hospital, Sydney, Australia;11. University of Sydney Medical School, Sydney, Australia;12. School of Medicine and Pharmacology, University of Western Australia, Perth, Australia;13. School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia;1. Dalhousie University/Nova Scotia Health Authority, 5082 Dickson Building, 5820, University Avenue, NS B3H 1V8 Halifax, Canada;2. Maisonneuve-Rosemont Hospital and Research Center, 5415, boulevard de l’Assomption, QC H1T 2M4 Montréal, Canada;1. Division of Nephrology, University of Toronto, University Health Network, 200 Elizabeth Street 8N-840, Toronto, ON M5G 2C4, Canada;2. Division of Nephrology, College of Medicine, King Saud University, King Khalid Street, Riyadh-Al-Diriyah 12372, Saudi Arabia;3. Division of Nephrology, University of Toronto, University Health Network/Toronto General Hospital, 200 Elizabeth Street, 8N-840, Toronto, Ontario M5G 2C4, Canada;1. Faculty of Medicine and Health Sciences, Keele University, Keele, UK;2. Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA;3. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA;4. Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA;5. Department of Urology, Medical School, University of Michigan, Ann Arbor, Michigan, USA;6. JAS Renaissance, Chicago, Illinois, USA;7. Medical University of Vienna, Vienna, Austria;8. Tsuchiya General Hospital, Hiroshima, Japan;9. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia;10. Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia;11. Translational Research Institute, Brisbane, Queensland, Australia;12. University of Hong Kong, Queen Mary Hospital, Hong Kong, China;13. Center of Excellence in Kidney Metabolic Disorders and Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok Thailand;14. Renal Unit, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;15. Pontificia Universidade Catolica do Parana, Curitiba, Brazil;16. St. George Hospital, Sydney, New South Wales, Australia;17. The George Institute for Global Health, University of New South Wales Medicine, Sydney, New South Wales, Australia;18. St. Michael’s Hospital, Toronto, Ontario, Canada |
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| Abstract: | BackgroundPeritoneal dialysis has become commonly used for renal replacement therapy; however, some patients withdraw from peritoneal dialysis due to complications, including peritoneal dialysis-related peritonitis, resulting in the low number of patients on peritoneal dialysis. Risk factors for peritoneal dialysis withdrawal due to peritoneal dialysis-related peritonitis are less certain. This retrospective study aimed to investigate these risk factors.MethodsWe retrospectively analyzed clinical characteristics, laboratory data, and causative microorganisms of 204 episodes of peritoneal dialysis-related peritonitis between 2007 and 2018 at our institution.ResultsOf the 204 episodes, 38 resulted in withdrawal from peritoneal dialysis due to peritoneal dialysis-related peritonitis. The number of peritonitis episodes per patient-year and the incidence of cardiovascular disease were significantly higher in the withdrawal group. Similarly, this group had low levels of serum creatinine, urea nitrogen, serum albumin, alanine aminotransferase, cholinesterase and high C-reactive protein, and second dialysate cell counts after antibiotic administration. Multivariate logistic regression analysis revealed that serum albumin (odds ratio: 0.465; 95% confidence interval: 0.249–0.868; P = 0.016) and cardiovascular disease (odds ratio: 2.508; 95% confidence interval: 1.184–5.315; P = 0.016) exhibited significant differences.ConclusionsThe results of this study suggest that hypoalbuminemia and the presence of cardiovascular disease were independent risk factors for withdrawal from peritoneal dialysis due to peritoneal dialysis-related peritonitis. |
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| Keywords: | Cardiovascular disease Hypoalbuminemia Peritoneal dialysis Peritoneal dialysis-related peritonitis Withdrawal |
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