Higher rate and earlier peritonitis in Aboriginal patients compared to non‐Aboriginal patients with end‐stage renal failure maintained on peritoneal dialysis in Australia: Analysis of ANZDATA

Lim, Wai H.; Johnson, David W.; McDonald, S.

doi:10.1111/j.1440-1797.2005.00374.x

Cited by 56 publications

(74 citation statements)

References 11 publications

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“…Other significant risk factors included age, black race, diabetes, peritonitis in the early period of PD, and congestive heart failure. The ANZDATA analysis, which included data on 3162 patients who started PD from 1999 to 2003, identified Aboriginal race, obesity, and older age as predictors of peritonitis (26). Moreover, in a Canadian study (27) of 4247 incident patients from 25 centers between January 1996 and September 2005, independent predictors of peritonitis included age, black race, diabetes among women, and transfer from HD to PD, whereas CAPD and APD had similar risk.…”

Section: Discussionmentioning

confidence: 99%

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Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Martin

Júnior

Fernandes

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil.Design, setting, participants, & measurements Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis.Results In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center.Conclusions Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities.

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Section: Discussionmentioning

confidence: 99%

“…Black race was identified several times as a peritonitis risk factor (3,4) and Aboriginal race was an independent predictor for peritonitis in the ANZDATA cohort (26). It is important to notice that non-white race in Brazil comprises not only black but also brown, yellow, and indigenous races.…”

Section: Discussionmentioning

confidence: 99%

Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Martin

Júnior

Fernandes

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…Most studies have reported either peritonitis rates or time to first peritonitis. Only two studies have compared analytic methods, demonstrating a tight correlation between a peritonitis rate analysis using a negative binomial model and an analysis of time to first peritonitis (3,26). In other words, it was shown that patients with a high peritonitis rate also tended to have a shorter time to their first peritonitis episode.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, a previous peritonitis episode has been shown to increase the risk for developing a subsequent episode (1,2). Although the association between age and peritonitis has been inconsistent across different studies (1,3,5,8,9), we recently reported an era effect for age, such that the increased risk associated with older age disappeared among those who initiated PD after the year 2000 (10). The data regarding other important factors are conflicting.…”

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confidence: 93%

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Predictors of Peritonitis in Patients on Peritoneal Dialysis

Nessim

Bargman

Austin

et al. 2009

Clinical Journal of the American Society of Nephrology

125

103

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Background and objectives: Despite the decreasing incidence of peritonitis among peritoneal dialysis (PD) patients over time, its occurrence is still associated with significant morbidity and mortality. Determining factors that are associated with PD peritonitis may facilitate the identification of patients who are at risk.Design, setting, participants, & measurements: Using data collected in the multicenter Baxter POET database between 1996 and 2005, the study population included incident Canadian PD patients. Potential predictors of peritonitis were sought using a negative binomial model and an Andersen-Gill model. Study variables included age, gender, race, cause of renal disease, diabetes status, transfer from hemodialysis (HD), previous renal transplant, and continuous ambulatory PD (CAPD) versus automated PD (APD).Results: Data were available for 4247 incident PD patients, including 1605 patients with a total of 2555 peritonitis episodes. Using the negative binomial regression model, factors that were independently associated with a higher peritonitis rate included age, Black race, and having transferred from HD. There was an interaction between gender and diabetes, with an increased risk for peritonitis among female patients with diabetes. The use of CAPD versus APD did not affect the peritonitis rate. The Andersen-Gill model for recurrent events yielded similar results.Conclusions: Predictors of PD peritonitis included Black race, transferring from HD to PD, and diabetes among women. In contrast to previous findings, CAPD and APD were similar with regard to peritonitis risk.

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Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients

Campbell

Mudge

Craig

et al. 2017

Cochrane Database of Systematic Reviews

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In this update, we identified limited data from RCTs and quasi-RCTs which evaluated strategies to prevent peritonitis and exit-site/tunnel infections. This review demonstrates that pre/peri-operative intravenous vancomycin may reduce the risk of early peritonitis and that antifungal prophylaxis with oral nystatin or fluconazole reduces the risk of fungal peritonitis following an antibiotic course. However, no other antimicrobial interventions have proven efficacy. In particular, the use of nasal antibiotic to eradicate Staphylococcus aureus, had an uncertain effect on the risk of peritonitis and raises questions about the usefulness of this approach. Given the large number of patients on PD and the importance of peritonitis, the lack of adequately powered and high quality RCTs to inform decision making about strategies to prevent peritonitis is striking.

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Higher rate and earlier peritonitis in Aboriginal patients compared to non‐Aboriginal patients with end‐stage renal failure maintained on peritoneal dialysis in Australia: Analysis of ANZDATA

Abstract: Aboriginal and obese PD patients have a higher rate of peritonitis and a shorter time to first peritonitis, independent of demographic and comorbid factors. Further investigation of the causes of increased peritonitis risk in Aboriginal patients is needed.

Cited by 56 publications

References 11 publications

Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Predictors of Peritonitis in Patients on Peritoneal Dialysis

Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients

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