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Abstract: FR-PO500

Risk Factors and Clinical Impact of Early-Onset Peritonitis in Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Paek, Jin hyuk, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Kim, Yaerim, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Park, Sung Bae, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Jin, Kyubok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
Background

Peritoneal dialysis (PD) related peritonitis is a serious complication of PD and the leading cause of technique failure. However, the impact of early peritonitis on PD survival is not clearly proven. This study aims to analyze the risk factors and outcomes of early-onset peritonitis.

Methods

We retrospectively reviewed 1336 patients who performed PD catheter implantation between 1996 and 2017. Of the 1336 patients, 614 patients who had at least one episode of peritonitis were enrolled. According to time from start of PD to first episode of peritonitis, patients were divided into early-onset (≤6 months) and late-onset (>6 months) peritonitis group.

Results

Among 614 patients, 164 (26.7%) patients developed their first episode of peritonitis within 6 months. The early-onset peritonitis group had more prevalence of diabetes mellitus (P = 0.004), lower serum albumin level at initiation of PD (P = 0.002) and higher peritonitis rate (P < 0.001) than the late-onset peritonitis group. Multivariate logistic regression analysis showed that risk factors associated with early-onset peritonitis were diabetes mellitus (OR 1.510, 95% CI 1.036-2.201, P = 0.032) and a lower serum albumin level at the start of PD (OR 0.629, 95% CI 0.434-0.910, P = 0.014). In multivariate Cox regression analysis, early-onset peritonitis was not an independent risk factor for technical failure and mortality. However, a negative correlation was observed between the time to first peritonitis and technical failure (HR 0.995, 95% CI 0.991-0.999, P = 0.023) and mortality (HR 0.991, 95% CI 0.987-0.997, P = 0.001). In the Spearman analysis, the time to first peritonitis was negatively correlated with the incidence of peritonitis (r = -0.437, P = 0.000).

Conclusion

Diabetes mellitus and a lower serum albumin level at initiation of PD were independent risk factors of early-onset peritonitis. Early-onset peritonitis was associated with higher incidence of peritonitis, technical failure and mortality.