title: Obligatory referral among other factors associated with peritonitis in peritoneal dialysis patients.
abstract: OBJECTIVE
  Peritonitis is one of the major comorbidities of peritoneal dialysis (PD) patients. The aim of this study was to concentrate on potential risk factors, including more recently studied ones among the classical ones for peritonitis, in PD patients.
  
  
  METHODS
  We analysed 109 patients (F/M = 42/67) followed up at least for 3 months in a single centre, a tertiary referral hospital for 360.1 patient years. In the study which is designed as a retrospective cohort study, demographic characteristics, conditions for choosing PD, type of PD treatment, some chemical tests and peritonitis episodes were recorded from the files of the patients.
  
  
  RESULTS
  The rate of peritonitis was found to be 0.22 episode/patient year and 22 (20.18%) of the patients had more than one episode. Twenty seven (24.8%) of the patients were allocated to PD due to obligatory reasons. According to multiple regression analysis, the associated factors were found to be PD allocation type (obligatory versus voluntary) (p = 0.04; RR = 2.6), serum albumin level (p = 0.05; RR = 1.2), and anti-hepatitis C Virus Antibody positivity (p = 0.03; RR = 1.6). Frequency of female patients were significantly higher in the group who had multiple episodes (p = 0.01).
  
  
  CONCLUSIONS
  Obligatory referral which can be an indication of loss of motivation for peritoneal dialysis procedures, is thought to be a strong risk factor for peritonitis in PD patients and should be further studied. Patients with multiple episodes had a higher frequency of obligatory referral as expected and additionally, they were higher in number of females when compared to the ones with single episode.
authors: Department of Nephrology, Istanbul University Cerrahpasa Medical Faculty, sht m eray sok 3, Istanbul, Turkey. derenoygar@yahoo.com
authors: D D
authors: DD
authors: Oygar
authors: A S
authors: AS
authors: Yalin
authors: M R
authors: MR
authors: Altiparmak
authors: R
authors: R
authors: Ataman
authors: K
authors: K
authors: Serdengecti
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D015331:Cohort Studies; D003928:Diabetic Nephropathies / Q000150:complications / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000523:psychology; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology*; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology