title: Treatment with oral active vitamin D is associated with decreased risk of peritonitis and improved survival in patients on peritoneal dialysis.
abstract: Peritonitis is a major complication of peritoneal dialysis (PD) being associated with hospitalization, catheter loss, technique failure, and increased mortality. Data on incidence rates and risk factors for peritonitis episodes vary between centers. In seven Austrian PD units clinical and laboratory data on each peritonitis episode were collected from all patients (n = 726) who performed PD between January 2000 and December 2009. The peritonitis incidence rate was 0.32 episodes/patient-year. In a multivariate analysis the risk of peritonitis was decreased by 57% in patients treated with oral active vitamin D (HR 0.43; 95% CI 0.28-0.64). Renal disease classified as "other or unknown" (HR 1.65; 95% CI 1.08-2.53) and serum albumin <3500 mg/dl (HR 1.49; 95% CI 1.04-2.15) were also associated with an increased risk of peritonitis. Albumin levels <3500 mg/dl (HR 1.89; 95% CI 1.13-3.17), age (HR 1.06 per year; 95% CI 1.03-1.09), and cardiomyopathy (HR 3.01; 95% CI 1.62-5.59) were associated with increased mortality, whereas treatment with oral active vitamin D was associated with a significantly lower risk of death (HR 0.46; 95% CI 0.27-0.81). In this retrospective multi-center study we identified several factors being related to increased risk of peritonitis in PD patients. Treatment with oral active vitamin D was identified as being independently associated with decreased risk of peritonitis, and decreased all-cause mortality in PD patients.
authors.affiliation: Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Kerschbaum
authors.forename: Andreas
authors.initials: A
authors.lastname: Vychytil
authors.forename: Karl
authors.initials: K
authors.lastname: Lhotta
authors.forename: Friedrich C
authors.initials: FC
authors.lastname: Prischl
authors.forename: Martin
authors.initials: M
authors.lastname: Wiesholzer
authors.forename: Veronika
authors.initials: V
authors.lastname: Machhold-Fabrizii
authors.forename: Gertrude
authors.initials: G
authors.lastname: Kopriva-Altfahrt
authors.forename: Christoph
authors.initials: C
authors.lastname: Schwarz
authors.forename: Peter
authors.initials: P
authors.lastname: Balcke
authors.forename: Rainer
authors.initials: R
authors.lastname: Oberbauer
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kramar
authors.forename: Paul
authors.initials: P
authors.lastname: König
authors.forename: Michael
authors.initials: M
authors.lastname: Rudnicki
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D009202:Cardiomyopathies / Q000150:complications; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000379:methods* / Q000401:mortality; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D015996:Survival Rate; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use*; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D012709:Serum Albumin; D014815:Vitamins; D014807:Vitamin D