Format

Send to

Choose Destination
Perit Dial Int. 2017 1-2;37(1):35-43. doi: 10.3747/pdi.2015.00141. Epub 2016 May 4.

Risk of Peritoneal Dialysis-Related Peritonitis in a Multi-Racial Asian Population.

Author information

1
Clinical Research Centre, Penang Hospital, Penang, Malaysia onglokemeng@gmail.com.
2
Clinical Research Centre, Penang Hospital, Penang, Malaysia.
3
Clinical Research Centre, Sultanah Aminah Hospital, Johor, Malaysia.
4
Department of Nephrology, Serdang Hospital, Selangor, Malaysia.
5
Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
6
Department of Nephrology, Tuanku Jaafar Hospital, Negeri Sembilan, Malaysia.
7
Department of Nephrology, Sultanah Aminah Hospital, Johor, Malaysia.

Abstract

♦ BACKGROUND: Peritonitis is one of the most common complications of peritoneal dialysis (PD). Understanding the risk factors of peritonitis in a multi-racial Asian population may help to improve outcomes on PD. ♦ METHODS: We conducted a prospective observational study to identify risk factors for PD-related peritonitis over a 1-year period in 15 adult PD centers. All peritonitis episodes were independently adjudicated. ♦ RESULTS: A total of 1,603 participants with a mean age of 51.6 years comprising 52.7% females, 62.6% ethnic Malays, 27.0% Chinese, and 8.1% Indians were recruited. The overall peritonitis rate was 1 episode per 44.0 patient-months with 354 episodes recorded in 282 (17.6%) patients over 15,588 patient-months. Significant risk factors of peritonitis were severe obesity (incidence-rate ratio [IRR] 3.32, 95% confidence interval [CI]: 1.30, 8.45), hypoalbuminemia (IRR 1.61, 95% CI: 1.06, 2.46), Staphylococcus aureus nasal carriage (IRR 2.26, 95% CI: 1.46, 3.50), and use of Fresenius system (Fresenius Medical Care North America, Waltham, MA, USA) (IRR 2.49, 95% CI: 1.27, 4.89). The risk of peritonitis was lower in those on automated PD compared with standard PD (IRR 0.43, 95% CI: 0.25, 0.74), and in centers with a patient-staff ratio of 15 to 29.9 (IRR 0.67, 95% CI: 0.49, 0.90) and ≥ 30 (IRR 0.52, 95% CI: 0.34, 0.80). Prevalent patients and exit-site care with topical antibiotics were also protective against peritonitis. Peritonitis rates varied between racial groups. The IRRs of overall peritonitis and gram-positive peritonitis in Chinese versus other racial groups were 0.65 (95% CI: 0.46, 0.90) and 0.47 (95% CI: 0.24, 0.91), respectively. ♦ CONCLUSIONS: Multiple patient, center, and PD-system factors influence the risk of peritonitis. In the Asian population, there are racial differences in the risk of peritonitis.

KEYWORDS:

Asian population; Peritoneal dialysis; center factors; patient factors; peritonitis; racial differences; risk factors; system factors

PMID:
27147287
DOI:
10.3747/pdi.2015.00141
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center