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Risk Factors for The First Episode of Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients in Pranangklao Hospital

Kittisak Tangjittrong MD¹ , ²

Affiliation : ¹ Division of Nephrology, Department of Medicine, Pranangklao Hospital, Nonthaburi, Thailand ² Faculty of Medicine, Siam University, Bangkok, Thailand

Background: Continuous ambulatory peritoneal dialysis (CAPD) is a renal replacement therapy for end stage renal disease patients. Peritonitis is a common complication in CAPD patients leading cause of technical failure and patient mortality. Investigating the risk for the first episode of peritonitis could help to prevent and improve CAPD outcomes.
Objective: To investigate the risk factors for the first episode of peritonitis in CAPD patients in Pranangklao Hospital.
Materials and Methods: A single-center, retrospective descriptive study was conducted to evaluate patients undergoing peritoneal dialysis (PD). All incident CAPD patients between October 1, 2011 and March 1, 2021 were recruited. Baseline demographic, and clinical and laboratory data were collected from medical records.
Results: In a cumulative 10,916.9 patient-months follow-up of the 411 CAPD patients, 227 were male and 184 were female. One hundred eighty- eight (45.7%) patients presented the first episode of peritonitis. The mean age of peritonitis free group and first peritonitis group was 58.2 years and 56.7 years, respectively. The mean duration from starting CAPD to the first episode of peritonitis was 19.4 months. The average peritonitis rate was 0.26 episodes per year, or one episode per 46.84 patient-months. There were no significant differences in clinical characteristics and laboratory data between these two groups, except there were more diabetes mellitus in the infectious peritonitis group at 72.6% versus 62.8% (p=0.03). Coagulase-negative Staphylococcus was the most common organism causing peritonitis. The multivariate logistic regression showed that diabetes mellitus (OR 1.59, 95% CI 1.03 to 2.46, p=0.04) was the risk factors associated with peritonitis.
Conclusion: Diabetes mellitus was the risk factor associated with the first episode of peritonitis. Therefore, special supervision should be provided to this group of patients by optimally controlling the diabetic conditions.
Received 10 August 2021 | Revised 28 November 2021 | Accepted 28 November 2021

doi.org/10.35755/jmedassocthai.2021.12.13194

Keywords : Continuous ambulatory peritoneal dialysis; First peritonitis episode; Risk factors


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