title: Steroid Use and Infectious Complication in Peritoneal Dialysis After Kidney Transplant Failure.
abstract: BACKGROUND
  Peritoneal dialysis (PD) is one potential treatment option for patients starting dialysis after graft loss (DAGL). However, the infectious outcomes and their associations with steroid use remain undetermined in these patients.
  
  
  METHODS
  A total of 41 DAGL patients undergoing PD were recruited. The patients were divided into low- and high-dose steroid groups according to the median level. Additionally, they were categorized into tapering and nontapering groups, for which the tapering regimen was defined as the withdrawal of steroids within 1 year after starting PD. Primary outcomes, such as peritonitis and exit site infection (ESI), were compared between DAGL and 712 transplant-naive (TN) patients.
  
  
  RESULTS
  The overall risk of peritonitis was similar between the TN and DAGL groups. However, when the DAGL group was stratified by the steroid variable, the risk was higher in the high-dose or nontapering steroid groups than in the TN or counterpart steroid groups. The DAGL group had a higher risk of ESI than the TN group, irrespective of steroid dose. When the analysis was stratified by tapering regimen, the difference in ESI risks was seen only in the nontapering group and the TN group; the tapering group had a similar risk of ESI as that of the TN group.
  
  
  CONCLUSIONS
  The present study first addresses the risks of peritonitis and ESI together and then raises awareness of the high risk that should be considered after using high-dose steroids or the nontapering regimen in the DAGL patients.
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Seung Seok
authors: SS
authors: Han
authors: Dong Ki
authors: DK
authors: Kim
authors: Kook-Hwan
authors: KH
authors: Oh
authors: Yon Su
authors: YS
authors: Kim
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D018570:Risk Assessment; D012307:Risk Factors; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D013256:Steroids