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PLoS One. 2019 Dec 12;14(12):e0225316. doi: 10.1371/journal.pone.0225316. eCollection 2019.

Effect of diabetes on incidence of peritoneal dialysis-associated peritonitis.

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Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.



Several reports on patients with diabetes mellitus (DM) treated by peritoneal dialysis (PD) have shown a higher risk of PD-associated peritonitis compared to non-DM (NDM) patients. The aim of this study was to investigate the incidence of PD-associated peritonitis in DM patients.


We divided all patients who received PD at a single center between January 1980 and December 2012 into three groups according to era: Period 1 (n = 43, 1980-1993); Period 2 (n = 123, 1994-2004); and Period 3 (n = 207, 2005-2012). We investigated incidences of PD-associated peritonitis between patients with and without DM.


In Periods 1 and 2, incidence of PD-associated peritonitis was higher in the DM group than in the NDM group (P<0.05). However, no difference according to presence of DM was seen in Period 3. Multivariate Cox regression analysis revealed DM as a risk factor for incidence of PD-associated peritonitis in Periods 1 and 2, but not in Period 3 (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.15 to 5.23; HR, 2.36; 95%CI, 1.13 to 4.58; and HR, 0.82; 95%CI, 0.41 to 1.54, respectively). Furthermore, the peritonitis-free period was significantly shorter in the DM group than in the DM group in Periods 1 and 2, whereas no significant difference was seen in Period 3 (P<0.01, P<0.01 and P = 0.55, respectively). Moreover, a significant interaction was seen between diabetes and study period, and became less pronounced during Period 3(P<0.01).


The increased risk of peritonitis in diabetics reported in previous periods has not been evident in recent years.

Conflict of interest statement

YM has received scholarship funds from Baxter International Inc. and Terumo Corporation. MI has received scholarship funds from Baxter International Inc. and Terumo Corporation. YT has received research grants from Baxter International Inc (grant number 16CECPDAP0002). This does not alter our adherence to PLOS ONE policies on sharing data and materials. Furthermore, there was nothing to declare with patent, product in development, and marked products. All other authors have no conflicts of interest to declare.

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