title: Impact of environmental particulate matter and peritoneal dialysis-related infection in patients undergoing peritoneal dialysis.
abstract: In patients undergoing peritoneal dialysis (PD), PD-related infection is a major cause of PD failure and hospital admission. Good air quality is required when dialysate exchange or exit site wound care is performed. To our knowledge, investigation of air pollution as a factor for PD-related infection in patients undergoing dialysis is limited. This study aimed to assess the effect of environmental particulate matter (PM) and other important risk factors on 1-year PD-related infection in patients undergoing PD.A total of 175 patients undergoing PD were recruited in this 1-year retrospective observational study. Differences in environmental PMs (PM10 and PM2.5) were analyzed with respect to the patients' living areas. The patients undergoing PD were categorized into 2 groups according to PM2.5 exposure: high (n = 61) and low (n = 114). Demographic, hematological, nutritional, inflammatory, biochemical, and dialysis-related data were analyzed. Multivariate binary logistic and multivariate Cox regression analyses were used to analyze 1-year PD-related infection.A total of 175 patients undergoing PD (50 men and 125 women) were enrolled. Thirty-five patients had PD-related infection within 1 year. Multivariate Cox regression analysis showed that high environmental PM2.5 exposure (hazard ratio (HR): 2.0, 95% confidence interval [CI] [1.03-3.91]; P = .04) and female sex (HR: 2.77, 95% CI [1.07-7.19]; P = .03) were risk factors for 1-year PD-related infection.Patients undergoing PD with high environmental PM2.5 exposure had a higher 1-year PD-related infection rate than that in those with low exposure. Therefore, air pollution may be associated with PD-related infection in such patients.
authors.affiliation: From the Department of Nephrology and Division of Clinical Toxicology (W-HH, T-HY); Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center (M-JC, Y-JS); and Chang Gung University College of Medicine, Taoyuan (W-HH, T-HY), Taiwan, Republic of China.
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Huang
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Chan
authors.forename: Yi-Jiun
authors.initials: YJ
authors.lastname: Su
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000009:adverse effects*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013624:Taiwan
chemical_list: D052638:Particulate Matter