Risk factors for peritoneal dialysis-related peritonitis: can we reduce the incidence and improve patient selection?
BACKGROUND
Peritonitis is a serious complication of peritoneal dialysis (PD) and a major cause of hospitalization, catheter loss, transfer to haemodialysis and death. Thus, it is important to identify risk factors for PD-related peritonitis in order to reduce the incidence and improve patient selection.


METHODS
This study is a prospective cohort review (1992-2003) with data consisting of 12,844 patient months, 506 PD patients and 623 episodes of peritonitis. Comorbidities and patient demographics were provided by the Australian and New Zealand Dialysis and Transplant Registry and these were merged with the hospital combined clinical and microbiology laboratory peritonitis database.


RESULTS
Variables identified to be associated with an increased likelihood of peritonitis were: age (every 10 years; OR, 1.26; 95% CI, 1.07-1.48), gender (female; OR, 1.91; 95% CI, 1.2-3.01), current smoker at entry to dialysis (OR, 1.71; 95% CI, 1.04-2.82) and the pre twin bag connection system (OR, 2.07; 95% CI, 1.22-3.52).


CONCLUSIONS
Increasing age, female gender and smoking increased the risk of peritonitis. Identifying these risk factors will assist in the selection, training and monitoring of our PD population.
Kotsanas
Despina
D
Department of Infectious Diseases, Southern Health - Monash Medical Centre, Clayton, Victoria, Australia. despina.kotsanas@southernhealth.org.au
Polkinghorne
Kevan R
KR
Korman
Tony M
TM
Atkins
Robert C
RC
Brown
Fiona
F
D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013021:South Australia / Q000453:epidemiology