title: High serum DcR3 levels are associated with the occurrence of peritonitis in patients receiving chronic peritoneal dialysis.
abstract: BACKGROUND
  Peritoneal dialysis (PD)-related peritonitis is a serious complication that typically leads to hospitalization, catheter loss, and even mortality. Previous studies of the risk factors for peritonitis are discordant. To date, no biomarker associated with PD-related peritonitis has been investigated. However, it has been shown that serum decoy receptor 3 (DcR3) is a valuable marker in predicting the outcome of several inflammatory diseases. The aim of this study was to investigate whether serum DcR3 is a predictor of peritonitis in chronic PD patients.
  
  
  METHODS
  We conducted a prospective cohort study of PD patients in the PD unit of a tertiary referral center from March 1 to November 30, 2007, and followed up until December 31, 2009. Clinical and laboratory parameters were recorded and serum DcR3 was measured to assess risk factors for developing PD-related peritonitis.
  
  
  RESULTS
  A total of 77 patients (38 men and 39 women; mean age 58 ± 13 years) were enrolled in this study. The average time on PD was 24.5 months and 46 patients (60%) were diabetic. The mean follow-up duration was 499 ± 17 days. The rate of peritonitis incidence was 0.17 episodes per patient-year. Baseline serum DcR3 in 77 patients was 1.94 ± 1.23 ng/mL. Kaplan-Meier survival analysis showed that patients with serum DcR3 > 1.8 ng/mL had a higher risk of peritonitis than those with serum DcR3 < 1.8 ng/mL (p = 0.016). The Cox proportional hazard model further showed that high serum DcR3 (>1.8 ng/mL) was an independent risk factor for subsequent peritonitis (hazard ratio 3.61, 95% CI 1.17-11.08; p = 0.03).
  
  
  CONCLUSIONS
  Serum DcR3 was associated with increased risk of PD-related peritonitis.
authors.affiliation: Division of Infectious Disease, Wei Gong Memorial Hospital, Miaoli, Taiwan, ROC.
authors.forename: En-Pen
authors.initials: EP
authors.lastname: Chang
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Szu-Chun
authors.initials: SC
authors.lastname: Huang
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Tarng
authors.forename: Tung-Po
authors.initials: TP
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D053323:Receptors, Tumor Necrosis Factor, Member 6b / Q000097:blood*; D012709:Serum Albumin / Q000032:analysis
chemical_list: D053323:Receptors, Tumor Necrosis Factor, Member 6b; D012709:Serum Albumin; C505911:TNFRSF6B protein, human; D002097:C-Reactive Protein