title: Higher serum C-reactive protein predicts short and long-term outcomes in peritoneal dialysis-associated peritonitis.
abstract: We examined the association between C-reactive protein (CRP) and short- and long-term adverse outcomes in peritoneal dialysis (PD)-associated peritonitis. Serum CRP levels were measured at baseline and 3 weeks after initiation of treatment in 209 patients with an incident episode of peritonitis between 1 January 1999 and 31 March 2005. Patients were followed until 31 May 2005. Short-term adverse outcomes included switch to hemodialysis, death, persistent infection beyond planned therapy duration, and relapse; long-term adverse outcomes included a subsequent peritonitis event or death. After adjustment for age, gender, diabetes, duration of renal replacement therapy and causative organism, patients with higher CRP levels at diagnosis had a greater odds of an adverse short-term outcome (odds ratio 1.57 (95% confidence interval (CI): 0.61-4.02), 2.73 (95% CI: 1.09-6.87), and 3.38 (95% CI: 1.36-8.42) in the second, third, and highest quartiles). In patients who met criteria for resolution of peritonitis 3 weeks after diagnosis, those with higher CRP levels had a greater risk of a long-term adverse outcome (hazard ratio 1.79 (95% CI: 1.05-3.07)). In conclusion, higher levels of CRP are independently associated with adverse outcomes in PD-associated peritonitis. Serial measurement of this marker during the course of peritonitis may facilitate earlier identification of individuals at greater risk of complications.
authors.affiliation: Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada. nadia@interchange.ubc.ca
authors.forename: N Y
authors.initials: NY
authors.lastname: Zalunardo
authors.forename: C L
authors.initials: CL
authors.lastname: Rose
authors.forename: I W Y
authors.initials: IW
authors.lastname: Ma
authors.forename: P
authors.initials: P
authors.lastname: Altmann
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000097:blood* / Q000209:etiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein