Peritoneal dialysis-related peritonitis: an analysis of risk factors in Northeast Anatolia*

Authors: MUSTAFA KELEŞ, RAMAZAN ÇETİNKAYA, ABDULLAH UYANIK, HAMİT ACEMOĞLU, FATMA SAATÇI, MUHAMMET HAMİDULLAH UYANIK

Abstract: Peritonitis is almost the most frequent complication of peritoneal dialysis (PD). Besides being the most frequent reason of hospitalization, peritonitis is also the most important determining factor of mortality-morbidity and technique survival among PD patients. In this study, it was aimed to identify the risk factors for peritonitis in these patients. Materials and methods: In this clinical cohort, records of 218 patients were collected between January 1998 and December 2007. The patients’ demographic, clinical, and laboratory parameters were recorded. Results were analyzed to compare patients who never had peritonitis and patients with at least one episode of peritonitis. Independent predictors of peritonitis were assessed using Cox regression, and the hazard ratio (HR) was determined using 95% confidence interval (95% CI). Results: Of over 6304 patient-months, 337 episodes of peritonitis were observed. The overall peritonitis rate was 0.64 attack/year. The risk of peritonitis was lower for PD patients with each 1 g/dL increase in mean albumin levels (HR, 0.39; 95% CI, 0.24-0.65; P < 0.001). Variables identified to be associated with an increased likelihood of peritonitis were: the placement of catheter via surgery (HR, 3.97; 95% CI, 2.16-7.29; P < 0.001), constipation (HR, 2.22; 95% CI, 1.26-3.92; P < 0.01), and amyloidosis (HR, 1.81; 95% CI, 0.93-3.50; P = 0.078). Conclusion: Hypoalbuminemia, constipation, the placement of catheter via surgery, and amyloidosis were found to increase the risk of peritonitis in the present study. Such risk factors should be kept in mind during follow-up of patients under PD.

Keywords: Peritoneal dialysis, peritonitis, risk factors

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