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Abstract: PO1279

Smoking Is a Risk Factor for Endogenous Peritonitis in Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Terada, Kohsuke, Department of Nephrology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
  • Hirama, Akio, Department of Nephrology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
  • Sakai, Yukinao, Department of Nephrology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
Background

Peritonitis is one of the most common complications observed in patients who are undergoing peritoneal dialysis (PD). PD-related peritonitis is associated with total mortality and transfer from PD to hemodialysis. Therefore, the prediction and prevention of peritonitis are important in PD patients. Exit-site infection (ESI) is an important risk factor for peritonitis. Whereas, there exists peritonitis without ESI and technical failure such as endogenous peritonitis in patients on PD. However, it is unclear that the prevention and prediction of endogenous peritonitis. Therefore, we investigated the risk of endogenous peritonitis in PD patients in this study.

Methods

We investigated the patients who were undergoing PD at our hospital and attended our hospital regularly from April 2015 to March 2020. We treated 22 cases of peritonitis in these patients; there were 18 cases of endogenous peritonitis without ESI and technical failure. We considered older age, female sex, obesity, diabetes mellitus, diverticulosis, and constipation as the important risk factors for endogenous peritonitis in patients undergoing PD. Therefore, we added these six factors as confounding factors with current and previous smoking history in the univariate logistic regression models. P values < 0.05 were considered statistically significant.

Results

We used univariate logistic regression models for the above-mentioned seven factors. Then, we defined age > 65 years as older age and body mass index > 25 as obesity. We defined patients who received purgative medication as having constipation. We found that diabetes mellitus (p = 0.0106), former or current smoking (p = 0.0065), and constipation (p = 0.0065) were statistically significant risk factors of endogenous peritonitis. Moreover, smoking and constipation were the most significant independent risk factors for endogenous peritonitis (p = 0.0036) in our multivariate logistic regression model.

Conclusion

In conclusion, smoking and constipation are significant independent risk factors of endogenous peritonitis in PD patients. The management of constipation and discontinuation of smoking may lower the risk of endogenous peritonitis in PD patients.