Socio-Economic Status and Peritonitis in Australian Non-Indigenous Peritoneal Dialysis Patients.
♦


BACKGROUND
The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis. ♦


METHODS
Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). ♦


RESULTS
7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 - 9; IRSD deciles 4 - 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer. ♦


CONCLUSIONS
In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories.
Division of Nephrology, Peking University Third Hospital, Beijing, China ANZDATA Registry, Adelaide, Australia Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia.
Wen
W
Tang
ANZDATA Registry, Adelaide, Australia.
Blair
B
Grace
ANZDATA Registry, Adelaide, Australia Department of Nephrology and Transplantation Services, University of Adelaide at Central Northern Adelaide Renal and Transplantation Services, Adelaide, Australia.
Stephen P
SP
McDonald
ANZDATA Registry, Adelaide, Australia Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia.
Carmel M
CM
Hawley
ANZDATA Registry, Adelaide, Australia Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia.
Sunil V
SV
Badve
ANZDATA Registry, Adelaide, Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, The University of Western Australia, Perth, Australia.
Neil C
NC
Boudville
ANZDATA Registry, Adelaide, Australia Department of Nephrology, Monash Medical Centre, Melbourne, Victoria, Australia.
Fiona G
FG
Brown
ANZDATA Registry, Adelaide, Australia Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia School of Public Health, University of Sydney, Sydney, Australia.
Philip A
PA
Clayton
ANZDATA Registry, Adelaide, Australia Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia david.johnson2@health.qld.gov.au.
David W
DW
Johnson
D000328:Adult; D000368:Aged; D001315:Australia; D015331:Cohort Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D010538:Peritonitis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016012:Poisson Distribution; D044382:Population Groups; D011204:Poverty Areas; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D016019:Survival Analysis
Peritoneal dialysis; education; income; mortality; outcomes; peritonitis; socio-economical status