The First Peritonitis Episode Alters the Natural Course of Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients

Diepen, Anouk T.N. van; Esch, Sadie van; Struijk, Dirk G.; Krediet, Raymond T.

doi:10.3747/pdi.2014.00277

Cited by 37 publications

(35 citation statements)

References 33 publications

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“…A multi-center study from Scotland showed that 42.2% of PD patients transferred to HD permanently due to peritonitis, and there was a significant correlation between peritonitis and technique failure [27]. After an attack of peritonitis, the structure and function of the peritoneum may be changed [28]. Repair of the peritoneum may be incomplete.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes of Early-Onset Peritonitis in Chinese Peritoneal Dialysis Patients

Tian

Xie

Xiang

et al. 2017

Kidney Blood Press Res

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Background/Aims: Studies on the risk factors and outcomes of peritonitis within the first 6 months in peritoneal dialysis patients are sparse. This study aims to investigate the risk factors associated with early-onset peritonitis (EOP) and its influence on patients’ technique survival and mortality. Methods: This is a retrospective observational cohort study. A total of 483 patients who had at least one episode of peritonitis were enrolled and followed from March 1, 2002, to August 31, 2016, at our center. According to the time to first peritonitis, we divided patients into two groups: EOP (≤ 6 months, n=167) and late-onset peritonitis (LOP, >6 months, n=316). Logistic regression was used to analyze the factors associated with EOP. A Cox proportional hazards model was constructed to examine the influence of EOP on clinical outcomes. Results: Of the 483 patients, 167 (34.6%) patients developed their first episode of peritonitis within the first 6 months. The EOP patient group had more male patients, a shorter time on peritoneal dialysis (PD), lower serum albumin levels at the time of PD initiation and a higher peritonitis rate (P<0.05). The EOP patient group had fewer infections with Gram-negative organisms (P=0.013) and more culture-negative peritonitis (P=0.014) than the LOP patient group for the first episode of peritonitis. The multivariate logistic regression analysis showed that factors associated with EOP included male gender (odds ratio (OR) 1.920, 95% confidence interval (CI) 1.272-2.897, P=0.002) and a low serum albumin level at the start of PD (OR 0.950, 95% CI 0.914-0.986, P=0.007). In the Cox proportional hazards model, EOP was a significant predictor of all-cause mortality (hazard ratio (HR) 2.766, 95% CI 1.561-4.900, P<0.001). There were no differences between EOP and LOP for technique failure. However, in continuous analyses, a negative correlation was observed between the time to first peritonitis and technique failure (HR 0.988, 95% CI 0.980-0.997, P=0.006). In the Spearman analysis, the time to first peritonitis was negatively correlated with the peritonitis rate (r=-0.573, P<0.001). Conclusion: Male gender and a low serum albumin level before PD were strongly associated with EOP. Additionally, EOP patients had a higher risk of poor clinical outcomes. More importantly, an early peritonitis onset was associated with a high peritonitis rate.

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Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes of Early-Onset Peritonitis in Chinese Peritoneal Dialysis Patients

Tian

Xie

Xiang

et al. 2017

Kidney Blood Press Res

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“…Persisting fibrotic response, angiogenesis, and ultrafiltration dysfunction were related to overexpression of IL-1B, whereas TNF induced transient changes in the peritoneal membrane [90]. A single episode of peritonitis has been shown to have a detrimental effect on the peritoneal membrane as measured by changes in solute transport rates [91,92].…”

Section: Risk Factors For Peritoneal Membrane Injurymentioning

confidence: 99%

Peritoneal Membrane Injury and Peritoneal Dialysis

Chugh

Chaudhry

Ryan

et al. 2014

Advances in Nephrology

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For patients with chronic renal failure, peritoneal dialysis (PD) is a common, life sustaining form of renal replacement therapy that is used worldwide. Exposure to nonbiocompatible dialysate, inflammation, and uremia induces longitudinal changes in the peritoneal membrane. Application of molecular biology techniques has led to advances in our understanding of the mechanism of injury of the peritoneal membrane. This understanding will allow for the development of strategies to preserve the peritoneal membrane structure and function. This may decrease the occurrence of PD technique failure and improve patient outcomes of morbidity and mortality.

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“…[1][2][3] Its occurrence is associated with hospitalization and death, increased PD-related treatment costs, and longterm adverse sequelae to peritoneal membrane structure and function. [4][5][6][7][8] The multistakeholder Standardised Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) study identified PD-related infection as part of a core outcome set for trials in patients receiving PD. 9,10 Better understanding regarding the incidence and prevalence of PD peritonitis episodes in a contemporary representative cohort of patients is needed to develop and evaluate peritonitis prevention strategies.…”

mentioning

confidence: 99%

Peritoneal Dialysis–Related Infection Rates and Outcomes: Results From the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

Perl

Fuller

Bieber

et al. 2020

American Journal of Kidney Diseases

158

109

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Peritoneal dialysis (PD)related peritonitis carries high morbidity for PD patients. Understanding the characteristics and risk factors for peritonitis can guide regional development of prevention strategies. We describe peritonitis rates and the associations of selected facility practices with peritonitis risk among countries participating in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).

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The First Peritonitis Episode Alters the Natural Course of Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients

Cited by 37 publications

References 33 publications

Risk Factors and Outcomes of Early-Onset Peritonitis in Chinese Peritoneal Dialysis Patients

Risk Factors and Outcomes of Early-Onset Peritonitis in Chinese Peritoneal Dialysis Patients

Peritoneal Membrane Injury and Peritoneal Dialysis

Peritoneal Dialysis–Related Infection Rates and Outcomes: Results From the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

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