title: Geographic and educational factors and risk of the first peritonitis episode in Brazilian Peritoneal Dialysis study (BRAZPD) patients.
abstract: OBJECTIVE
  Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil.
  
  
  METHODS
  Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis.
  
  
  RESULTS
  In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center.
  
  
  CONCLUSIONS
  Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities.
authors: Department of Internal Medicine, Botucatu Medical School, 18618-000 Botucatu, Sao Paulo, Brazil.
authors: Luis C
authors: LC
authors: Martin
authors: Jacqueline C T
authors: JC
authors: Caramori
authors: Natalia
authors: N
authors: Fernandes
authors: Jose C
authors: JC
authors: Divino-Filho
authors: Roberto
authors: R
authors: Pecoits-Filho
authors: Pasqual
authors: P
authors: Barretti
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000401:mortality; D010538:Peritonitis / Q000208:ethnology / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome