title: Risk Factors for Early-Onset Peritonitis in Southern Chinese Peritoneal Dialysis Patients.
abstract: ♦ BACKGROUND: Early peritonitis was confirmed to be associated with a higher risk of early technique failure. However, literature concerning peritonitis within the first 3 months of peritoneal dialysis (PD) initiation is scarce. The present study was to investigate risk factors associated with early-onset peritonitis in PD patients. ♦ METHODS: In this retrospective observational cohort study, all incident PD patients from January 1, 2006, to December 31, 2013, were recruited and followed up until December 31, 2014. According to time-to-first episode of peritonitis, patients were divided into early-onset (≤ 3 months) peritonitis and late-onset (> 3 months) peritonitis. Baseline demographic, clinical, and laboratory data, as well as episodes of peritonitis, were collected. Risk factors associated with early-onset peritonitis were evaluated using logistic regression model. ♦ RESULTS: Of 1,690 patients on PD, 503 (29.8%) developed at least 1 episode of peritonitis and 118 (7.0%) patients presented the first episodes of peritonitis within the first 3 months. A multivariate logistic analysis showed that higher body mass index (BMI) (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.01 - 1.15, p = 0.034), hypoalbuminemia (OR 1.75, 95% CI 1.11 - 2.78, p = 0.017), and catheter exit-site infection (OR 4.14, 95% CI 2.45 - 7.00, p < 0.001) were risk factors independently associated with early-onset peritonitis. Compared to those with late-onset, patients with early-onset peritonitis had a higher overall peritonitis rate (0.76 vs 0.38 per patient-year, p < 0.001) and worse technique survival (p < 0.001), while patient survival did not differ significantly between the 2 groups during the long-term follow-up (p > 0.05). ♦ CONCLUSIONS: Higher BMI, hypoalbuminemia, and catheter exit-site infection were the risk factors associated with early-onset peritonitis in PD patients.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China.
authors.forename: Haishan
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China.
authors.forename: Rong
authors.initials: R
authors.lastname: Huang
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Yi
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China.
authors.forename: Qunying
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China.
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, People's Republic of China; and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, People's Republic of China yangxsysu@126.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015992:Body Mass Index; D055499:Catheter-Related Infections / Q000150:complications*; D002681:China; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D006785:Hospitals, University; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications*; D017053:Infection Control / Q000379:methods; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Early-onset peritonitis; outcome; peritoneal dialysis; risk factor