Abstract: FR-PO944

Peritoneal Dialysis-Related Peritonitis in the Era of the Elderly Dialysis Population: A Retrospective, Multicenter Study in Thailand

Session Information

  • Geriatric Nephrology
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

  • 901 Geriatric Nephrology

Authors

  • Koyratkoson, Kiatkriangkrai, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
  • nochaiwong, surapon, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
  • Ruengorn, Chidchanok, Facultty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
  • Chaisai, Chayutthaphong, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
  • Noppakun, Kajohnsak, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Awiphan, Ratanaporn -, Chiangmai University, Chiangmai, Thailand
  • Chongruksut, Wilaiwan -, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Nanta, Sirisak, Maesai District Hospital, Chiang Rai, Thailand, Chiang Rai, Thailand

Group or Team Name

  • Thai Renal Outcomes Research (THOR) Investigators
Background

Peritonitis, a major complication of peritoneal dialysis (PD), contributes to treatment failure, hospitalization, and mortality, particularly in elderly PD cases. Regardless of technical problems, social difficulties, and burden of comorbidities, it remains debated whether elderly patients have a significantly amplified risk of peritonitis than younger patients. Thus, we aimed to evaluate the impact of advanced age on the risk of PD-related peritonitis.

Methods

We conducted a retrospective cohort study using the PD registry database of an incident PD patients with aged ≥ 18 years. At PD initiation, subjects were categorized into <55, 55-65, and >65 years of age groups. Clinical characteristics regarding age groups were compared among participants from three large PD centers in Thailand between January 2006 and December 2016, and followed through April 2017. Time-to-first PD-related peritonitis and longitudinal rates were analyzed by multivariable Cox’s proportional hazards model and Poisson regression, respectively.

Results

Among 1,023 PD patients included, 401 (39.2%), 312 (30.5%), and 310 (30.3%) patients aged <55, 55-65, and >65 years, respectively. After a total follow-up of 19,463.4 person-months, 519 (50.7%) were recognized as having PD-related peritonitis. There was no significant difference in spectra of causative microorganisms among patient age groups.

Conclusion

The risk of first episode peritonitis is not increased in elderly PD patients, however, compared with younger patients, the higher peritonitis rate was observed in elderly PD patients. Large prospective trials are needed to validate these findings.

Hazard Ratios for First Episode PD-Related Peritonitis and Incidence Rate Ratio for Longitudinal PD-Related Peritonitis Rates by Patients’ Age Group (n=1,023)
Patients by Age GroupCrude HR (95% CI)P ValueAdjusted HR (95% CI)P ValueCrude IRR (95% CI)P ValueAdjusted IRR (95% CI)P Value
< 55 yearsReference Reference Reference Reference 
55 – 65 years1.18 (0.96 – 1.45)0.1181.13 (0.74 – 1.72)0.5621.13 (0.98 – 1.30)0.0971.20 (0.91 – 1.59)0.195
> 65 years1.42 (1.14 – 1.75)0.0011.37 (0.78 – 2.40)0.2721.54 (1.32 – 1.79)<0.0011.66 (1.14 – 2.39)0.007

Abbreviations: CI, confidence interval; HR, hazard ratio; IRR, incidence rate ratio; PD, peritoneal dialysis.

Funding

  • Government Support - Non-U.S.