Abstract
Objective: Peritonitis is a severe complication in peritoneal dialysis (PD). This study was performed to identify predictors and establish a risk score for treatment failure in peritonitis patients.Methods: A single-center, retrospective observational study was conducted. The basic demographic characteristics, clinical and laboratory data of all patients with peritonitis during the study period were documented and analyzed. Multivariate logistic regression was applied to examine independent predictors of treatment failure, and a risk prediction score was established.Results: Three hundred fourteen episodes experienced by 241 patients were included in the final analysis. Logistic regression analysis indicated that PD duration (OR 1.017; P 0.005), fibrinogen (OR 1.327; P 0.021), high-density lipoprotein (OR 0.443; P 0.032), fungal infection (OR 63.413; P < 0.001), intestinal obstruction (OR 5.186, P 0.007), and diabetes mellitus (OR 2.451; P 0.018), hemodialysis history (OR 2.804, P 0.006) were independent predictors of treatment failure. The risk prediction score system showed a good calibration (P > 0.05) and discrimination (AUROC 0.80, P < 0.001).Conclusions: Fibrinogen, PD duration, fungal infection, hemodialysis history, concurrent intestinal obstruction, or diabetes mellitus were independent risk factors for a poor peritonitis outcome, while the high-density lipoprotein was a protective factor. This novel risk prediction score system may be used to predict a high risk of treatment failure effectively.
Highlights
Peritoneal dialysis (PD) is one of the main renal replacement treatments for patients with end-stage renal diseases (ESRD), accounting for about 11% of global dialysis patients [1]
Clinical Features of Peritonitis OutcomesPD-associated peritonitis (PDAP) Categorized by Treatment Outcomes
Among the 314 PDAP episodes included in the current study, treatment success was achieved in 249 (79.3%) episodes, and the remaining 65 (20.7%) episodes resulted in treatment failure
Summary
Peritoneal dialysis (PD) is one of the main renal replacement treatments for patients with end-stage renal diseases (ESRD), accounting for about 11% of global dialysis patients [1]. It provides a similar or better survival outcome vs, hemodialysis (HD) [2] and is more cost-effective. This therapy utilization has decreased recently in some countries due to shortage of high-quality evidence for prevention of peritonitis, poor control of dialysis center infections, and relatively high technique failure rate [3, 4]. Despite the guidelines of PDAP, there are still considerably baffling variations in treatment outcomes of peritonitis in many centers and countries [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
