Persistent overhydration associates a significant risk of peritoneal infection with enteric germs in patients treated with peritoneal dialysis

Fiel, David; Pérez‐Fontán, Miguel; Iglesias, Alfonso; González-Blas, Luis Bravo; Gago, Leticia García; Falcón, Teresa García; Rodríguez‐Carmona, Ana

doi:10.1016/j.nefroe.2019.01.011

Cited by 7 publications

(19 citation statements)

References 28 publications

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“…In the study, we found the relationship between peritonitis and overhydration ( Table 2,3). The result of our study was similar to others [13,14]. The association between OH and peritonitis maybe by enteric germs [14].…”

Section: Prevalence Peritonitissupporting

confidence: 92%

“…The result of our study was similar to others [13,14]. The association between OH and peritonitis maybe by enteric germs [14]. This seems to be reasonable, by a trend toward an association between baseline levels of C-reactive protein and the PD-related peritonitis ( Table 2,3).…”

Section: Prevalence Peritonitissupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

Quy

Huy

Duc³

et al. 2020

Preprint

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Background In this study, we focused on the role of overhydration (OH) and low serum prealbumin concentration in predicting 3-year peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patientsMethods We measured serum prealbumin concentration and OH by body composition monitor on 278 CAPD patients (159 males and 119 females) to predict 3-year peritonitis. We created the baseline demographics of all patients with the mean age of 46 years and the median peritoneal dialysis (PD) duration of 21 months.Results After the 3-year follow-up, 44 patients diagnosed PD-related peritonitis (15.8%). Low education, serum albumin, prealbumin, high CRP-hs and OH were independent risk factors for predicting peritonitis during 36 months in CAPD patients. Based on the Kaplan–Meier analysis, we realized that patients with low prealbumin and high OH were the good predictors of 3-year peritonitis in CAPD patients (Prealbumin: AUC = 0.838, cut-off value = 32.5 mg/dL, Se = 90.9%, OH: AUC = 0.851, cut-off value = 1.33 L, Se = 79.5%, Sp = 85.5%), (Log-rank test p < 0.001).Conclusion Overhydration and low serum prealbumin level were the good predictors of PD-related peritonitis in CAPD patients.

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Section: Prevalence Peritonitissupporting

confidence: 92%

Section: Prevalence Peritonitissupporting

confidence: 91%

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Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

Quy

Huy

Duc³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Prealbumin levels were an independent and sensitive predictor for mortality in incident PD patients, showing a good correlation with nutritional and in ammatory markers [16,31]. Association between OH and the risk of peritoneal infection by enteric germs was reported in Carvalho Fiel D's study [14]. It has been suggested that persistent oedema of the intestinal wall may favour microbial and bacterial endotoxin transmigration, in some cases leading to systemic infections including peritonitis [14].…”

Section: Factors Predict Peritonitismentioning

confidence: 91%

“…Similar to other countries in the world, peritonitis always happens and many patients have to switch to maintenance hemodialysis. Overhydration (OH) complicates frequently the clinical course of PD patients and keeps a controversial association with the risk of peritoneal infection [13,14]. Beside, prealbumin (transthyretin) is a hepatic secretory protein used to assess malnutrition in PD patients, had a prognostic value of peritonitis and mortality in PD patients [15,16].…”

Section: Introductionmentioning

confidence: 99%

Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

Quy

Huy

Duc³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In this study, we focused on the role of overhydration (OH) and low serum prealbumin concentration in predicting 3-year peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods: We measured serum prealbumin concentration and OH by body composition monitor on 278 CAPD patients (159 males and 119 females) with mean age of 46 years and the median peritoneal dialysis (PD) duration of 21 months. PD-related peritonitis was collected for 3 years. Results: After the 3-year follow-up, 44 patients diagnosed PD-related peritonitis (15.8%). Low education, serum albumin, prealbumin, high CRP-hs and OH were independent risk factors for predicting peritonitis during 36 months in CAPD patients. Based on the ROC curve model and Kaplan–Meier analysis, we realized that patients with low prealbumin and high OH were the independent predictors of 3-year peritonitis in CAPD patients (Prealbumin: AUC = 0.838, cut-off value = 32.5 mg/dL, Se= 90.9%, Sp = 32.9%; OH: AUC = 0.851, cut-off value = 1.33 L, Se = 79.5%, Sp = 85.5%; and Log-rank test p < 0.001, respectively). Conclusion: Overhydration and low serum prealbumin level were the independent predictors of PD-related peritonitis in CAPD patients.

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Risk factors of peritoneal dialysis–related peritonitis in the Japan Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

Ito,

Tu,

Yamaguchi

et al. 2024

Clinical Kidney Journal

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Background Peritoneal dialysis (PD)-related peritonitis is a major complication of PD. Wide variations in peritonitis prevention, treatment strategies, and consequences are seen between countries. These between-country differences may result from modifiable risk factors and clinical practices. Methods A total of 1225 Japanese PD patients were included and prospectively followed in the Peritoneal Dialysis Outcomes and Practice Patterns Study phase 1 (2014–2018) and phase 2 (2018–2022). Associations between PD-related peritonitis and various risk factors were assessed by Cox proportional hazards survival models. Results During follow-up (median 1.52 years), 539 peritonitis episodes were experienced by 364 patients. The country crude peritonitis rate was 0.27 episodes/patient-year. In the fully adjusted model, noticeable patient-level factors associated with experiencing any peritonitis included age (hazard ratio [HR], 1.07 per 5-year increase; 95% confidence interval [CI], 1.01–1.14), serum albumin level (HR, 0.63 per 1 g/dL higher; 95% CI, 0.48–0.82) and continuous ambulatory peritoneal dialysis (HR, 1.31 vs automated PD; 95% CI, 1.05–1.63). The adoption of antibiotic prophylaxis practice at the time of PD catheter insertion (HR, 0.63; 95% CI, 0.51–0.78), or when having complicated dental procedures (HR, 0.74; 95% CI, 0.57–0.95), or lower endoscopy (HR, 0.69; 95% CI, 0.54–0.89) were associated with lower hazards of any peritonitis while a routine facility practice of having more frequent regular medical visits was associated with a higher hazard. Conclusion Identification of risk factors in Japan may be useful for developing future versions of guidelines and improving clinical practices in Japan. Investigation of country-level risk factors for PD-related peritonitis is useful for developing and implementing local peritonitis prevention and treatment strategies.

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Persistent overhydration associates a significant risk of peritoneal infection with enteric germs in patients treated with peritoneal dialysis

Cited by 7 publications

References 28 publications

Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

Risk factors of peritoneal dialysis–related peritonitis in the Japan Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

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