TY - JOUR
T1 - Factors associated with time to first dialysis-associated peritonitis episode
T2 - Data from the Peritonitis Prevention Study (PEPS)
AU - Ljungman, Susanne
AU - Jensen, Jørgen E
AU - Paulsen, Dag
AU - Petersons, Aivars
AU - Ots-Rosenberg, Mai
AU - Saha, Heikki
AU - Struijk, Dirk
AU - Wilkie, Martin
AU - Heimbürger, Olof
AU - Stegmayr, Bernd
AU - Elung-Jensen, Thomas
AU - Johansson, Ann-Cathrine
AU - Rydström, Margareta
AU - Gudmundsdottir, Helga
AU - Hussain-Alkhateeb, Laith
AU - Peritonitis Prevention Study (PEPS) Trial Investigators
N1 - Funding Information:
The authors declare the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SL received a research grant from Baxter Healthcare Corporation that partly funded this trial. OH declared having served on advisory boards of AstraZeneca, Vifor, Opterion and Gilead and has received speaker’s honoraria from AstraZeneca, Vifor, Baxter Healthcare Corporation and Fresenius Medical Care, which has no bearing on the submitted work. MW is Advisory Editor and OH is a member of the Editorial board of Peritoneal Dialysis International. The handling of and decision-making regarding this manuscript was taken care of by other members of the editorial board. MW has received a research grant from Baxter Healthcare Corporation and speaker’s honoraria from Baxter Healthcare Corporation and Fresenius Medical Care, and has served as a consultant to Triomed AB, which has no bearing on the submitted work. All the other authors declared no competing interests.
Funding Information:
The author(s) received financial support for the research, authorship, and/or publication of this article: The trial was supported by The Health & Medical Care Committee of The Regional Executive Board, Region West of Sweden (VGFOUREG-78061, 226521 and 383641), Baxter Healthcare Corporation (McGaw Park, IL, USA; Clinical Evidence Council grant number 10CECEU1004), Swedish Society of Nephrology, The Swedish Kidney Association, The Society of Kidney Patients in West of Sweden, The John and Brit Wennerström Foundation, The Bertil and Berit Adström Foundation, The Foundation for Kidney Failure (Sweden), The Swedish Kidney Foundation and Norwegian Society of Kidney Patients. The funders did not have any role in the study design, data collection, analysis, reporting, or the decision to submit the manuscript for publication.
Publisher Copyright:
© The Author(s) 2023.
PY - 2023/5
Y1 - 2023/5
N2 - INTRODUCTION: Peritonitis remains a potentially serious complication of peritoneal dialysis (PD) treatment. It is therefore important to identify risk factors in order to reduce the incidence of peritonitis. The aim of the present analysis was to identify factors associated with time to first peritonitis episode.METHODS: Incident PD patients from 57 centres in Europe participated in the prospective randomised controlled Peritonitis Prevention Study (PEPS) from 2010 to 2015. Peritonitis-free, self-care PD patients ≥18 years were randomised to a retraining or a control group and followed for 1-36 months after PD initiation. The association of biochemical, clinical and prescription data with time to first peritonitis episode was studied.RESULTS: A first peritonitis episode was experienced by 33% (223/671) of participants. Univariable Cox proportional hazard regression showed a strong association between the time-updated number of PD bags connected per 24 h (PD bags/24 h) and time to first peritonitis episode (HR 1.35; 95% confidence interval (CI) 1.17-1.57), even after inclusion of PD modalities in the same model. Multivariable Cox regression revealed that the factors independently associated with time to first peritonitis episode included age (HR 1.16 per 10 years; 95% CI 1.05-1.28), PD bags/24 h (HR 1.32; 95% CI 1.13-1.54), serum albumin <35 versus >35 g/L (HR 1.39; 95% CI 1.06-1.82) and body weight per 10 kg (HR 1.10; 95% CI 1.01-1.19).CONCLUSION: This study of incident PD patients indicates that older age, greater number of PD bags connected/24 h, higher body weight and hypoalbuminaemia are independently associated with a shorter time to first peritonitis episode.
AB - INTRODUCTION: Peritonitis remains a potentially serious complication of peritoneal dialysis (PD) treatment. It is therefore important to identify risk factors in order to reduce the incidence of peritonitis. The aim of the present analysis was to identify factors associated with time to first peritonitis episode.METHODS: Incident PD patients from 57 centres in Europe participated in the prospective randomised controlled Peritonitis Prevention Study (PEPS) from 2010 to 2015. Peritonitis-free, self-care PD patients ≥18 years were randomised to a retraining or a control group and followed for 1-36 months after PD initiation. The association of biochemical, clinical and prescription data with time to first peritonitis episode was studied.RESULTS: A first peritonitis episode was experienced by 33% (223/671) of participants. Univariable Cox proportional hazard regression showed a strong association between the time-updated number of PD bags connected per 24 h (PD bags/24 h) and time to first peritonitis episode (HR 1.35; 95% confidence interval (CI) 1.17-1.57), even after inclusion of PD modalities in the same model. Multivariable Cox regression revealed that the factors independently associated with time to first peritonitis episode included age (HR 1.16 per 10 years; 95% CI 1.05-1.28), PD bags/24 h (HR 1.32; 95% CI 1.13-1.54), serum albumin <35 versus >35 g/L (HR 1.39; 95% CI 1.06-1.82) and body weight per 10 kg (HR 1.10; 95% CI 1.01-1.19).CONCLUSION: This study of incident PD patients indicates that older age, greater number of PD bags connected/24 h, higher body weight and hypoalbuminaemia are independently associated with a shorter time to first peritonitis episode.
KW - Peritoneal dialysis
KW - peritonitis
KW - risk factors
UR - https://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/MEDLINE:37021365
UR - https://pubmed.ncbi.nlm.nih.gov/37021365/
UR - http://www.scopus.com/inward/record.url?scp=85153748830&partnerID=8YFLogxK
U2 - 10.1177/08968608231161179
DO - 10.1177/08968608231161179
M3 - Article
C2 - 37021365
SN - 0896-8608
VL - 43
SP - 241
EP - 251
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
IS - 3
ER -