title: The changing trends of peritoneal dialysis related peritonitis and novel risk factors.
abstract: OBJECTIVE
  Continuous ambulatory peritoneal dialysis (PD) has become a treatment modality for end stage renal disease with a peak of its use in 1990 s. The aim of this study was to examine the peritonitis rates, causative organisms and the risk factors of peritonitis in a large group of patients in our center.
  
  
  METHODS
  The study was conducted in the Nephrology Department of a University Hospital in Turkey. Patients in the PD programme between January 2000 and January 2006 were included. Cohort-specific and subject specific peritonitis incidence, and peritonitis-free survival were calculated. Causative organisms and risk factors were evaluated.
  
  
  RESULTS
  Totally 620 episodes of peritonitis occurred in 440 patients over the six years period. Peritonitis rates showed a decreasing trend through the years (0.79 episodes/patient-year 2000-2003 and 0.46 episodes/patient-year 2003-2006). Cohort-specific peritonitis incidence was 0.62 episodes/patient-years and median subject-specific peritonitis incidence was 0.44 episodes/patient-years. The median peritonitis-free survival was 15.25 months (%95 CI, 9.45-21.06 months). The proportion of gram-negative organisms has increased from 9.8% to 17.3%. There was a significant difference in the percentage of culture negative peritonitis between the first three and the last three years (53.1% vs. 43.2%, respectively). Peritonitis incidence was higher in patients who had been transferred from HD, who had catheter related infection and who had HCV infection without cirrhosis.
  
  
  CONCLUSIONS
  Our study showed significant trends in the peritonitis rates, causative organisms and antibiotic resistance. Prior HD therapy, catheter related infections and HCV infection were found to be risk factors for peritonitis.
authors.affiliation: a Department of Internal Medicine , Hacettepe University Faculty of Medicine, Ankara , Turkey and.
authors.forename: Lale
authors.initials: L
authors.lastname: Ozisik
authors.affiliation: b Department of Nephrology , Baskent University Faculty of Medicine, Ankara , Turkey.
authors.forename: Fatma Nurhan
authors.initials: FN
authors.lastname: Ozdemir
authors.affiliation: a Department of Internal Medicine , Hacettepe University Faculty of Medicine, Ankara , Turkey and.
authors.forename: Mine Durusu
authors.initials: MD
authors.lastname: Tanriover
mesh_terms: D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D002408:Catheters, Indwelling / Q000009:adverse effects; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006785:Hospitals, University; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey
keywords: Etiologic agent; peritoneal dialysis; peritonitis; peritonitis rate; risk factor