RISK FACTORS FOR PERITONEAL DIALYSIS ASSOCIATED PERITONITIS

Background and aim: Peritonitis remains an important peritoneal dialysis (PD) related complication nowadays. There has been a dramatic reduction in the incidence rate of PD-related peritonitis because of improved catheter and connection systems technologies and, most importantly, effective patient education.
Methods: This is a retrospective single-center study of 158 hospitalizations in patients with end stage renal disease and inserted PD catheters (n =80) during one year (2015). The data was collected from the Latvian Nephrology Centre inpatient database. Twelve patients for whom PD was not started and 13 with missing data were excluded from the analysis. A multivariate analysis was performed in study patients with peritonitis (group A) or without peritonitis (control group B). Variables included age, gender,
concomitant disease - diabetes mellitus, body mass index [BMI], hemoglobin [Hb], potassium [K], phosphate [P], albumin [Alb], PD quality test [Kt/v], duration of PD in months, assistance for PD. The PD-related peritonitis risk (odds ratio, OR) was estimated using binary logistic regression analysis (SPSS 20.0 version for Mac). A p value ≤ 0.05 was considered statistically significant.
Results: A total of 55 PD patients (group A, n =17; group B, n =38) were analyzed. There is no statistically significant difference regarding the risk of peritonitis (OR) between unadjusted groups: 0.93, p =0.91 for old patients; 0.65, p =0.46 for males; 0.71, p =0.67 for diabetic patients; 0.52, p =0.38 for obesity (BMI >=30 kg/m2); 1.5, p =0.64 for anemic patients (Hb <12 g/dl for males and Hb <11 g/dl for females); 4.2, p =0.25 for patients with hypokalemia (K <3.5 mmol/l); 1.3, p =0.75 for patients with hyperphosphatemia (P >1.5 mmol/l); 1.8, p =0.47 for non-assisted PD patients; 2.7, p =0.12 for short time on PD (less than one year); 0.83, p =0.90 for hypoalbuminemia (Alb <35 g/l). Odds ratio for adequacy of PD (Kt/v >2) was 0.09 (p=0.02), but after adjustment for diabetes mellitus, obesity and PD length it was not significant (OR 0.09, p =0.07).
Conclusions: According to this study, there are no identified risk factors for PD-related peritonitis. Our study has following limitations: retrospective data, small number of patients, inadequate control group selection.