Cargando…

The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients

BACKGROUND: Results concerning the association between peritoneal dialysis-related peritonitis and mortality in peritoneal dialysis patients are inconclusive, with one potential reason being that the time-dependent effect of peritonitis has rarely been considered in previous studies. This study aime...

Descripción completa

Detalles Bibliográficos
Autores principales: Ye, Hongjian, Zhou, Qian, Fan, Li, Guo, Qunying, Mao, Haiping, Huang, Fengxian, Yu, Xueqing, Yang, Xiao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460447/
https://www.ncbi.nlm.nih.gov/pubmed/28583107
http://dx.doi.org/10.1186/s12882-017-0588-4
_version_ 1783242175600918528
author Ye, Hongjian
Zhou, Qian
Fan, Li
Guo, Qunying
Mao, Haiping
Huang, Fengxian
Yu, Xueqing
Yang, Xiao
author_facet Ye, Hongjian
Zhou, Qian
Fan, Li
Guo, Qunying
Mao, Haiping
Huang, Fengxian
Yu, Xueqing
Yang, Xiao
author_sort Ye, Hongjian
collection PubMed
description BACKGROUND: Results concerning the association between peritoneal dialysis-related peritonitis and mortality in peritoneal dialysis patients are inconclusive, with one potential reason being that the time-dependent effect of peritonitis has rarely been considered in previous studies. This study aimed to evaluate whether peritonitis has a negative impact on mortality in a large cohort of peritoneal dialysis patients. We also assessed the changing impact of peritonitis on patient mortality with respect to duration of follow-up. METHODS: This retrospective cohort study included incident patients who started peritoneal dialysis from 1 January 2006 to 31 December 2011. Episodes of peritonitis were recorded at the time of onset, and peritonitis was parameterized as a time-dependent variable for analysis. We used the Cox regression model to assess whether peritonitis has a negative impact on mortality. RESULTS: A total of 1321 patients were included. The mean age was 48.1 ± 15.3 years, 41.3% were female, and 23.5% with diabetes mellitus. The median (interquartile) follow-up time was 34 (21–48) months. After adjusting for confounders, peritonitis was independently associated with 95% increased risk of all-cause mortality (hazard ratio, 1.95; 95% confidence interval: 1.46–2.60), 90% increased risk of cardiovascular mortality (hazard ratio, 1.90; 95% confidence interval: 1.28–2.81) and near 4-fold increased risk of infection-related mortality (hazard ratio, 4.94; 95% confidence interval: 2.47–9.86). Further analyses showed that peritonitis was not significantly associated with mortality within 2 years of peritoneal dialysis initiation, but strongly influenced mortality in patients dialysed longer than 2 years. CONCLUSIONS: Peritonitis was independently associated with higher risk of all-cause, cardiovascular and infection-related mortality in peritoneal dialysis patients, and its impact on mortality was more significant in patients with longer peritoneal dialysis duration. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-017-0588-4) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-5460447
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-54604472017-06-07 The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients Ye, Hongjian Zhou, Qian Fan, Li Guo, Qunying Mao, Haiping Huang, Fengxian Yu, Xueqing Yang, Xiao BMC Nephrol Research Article BACKGROUND: Results concerning the association between peritoneal dialysis-related peritonitis and mortality in peritoneal dialysis patients are inconclusive, with one potential reason being that the time-dependent effect of peritonitis has rarely been considered in previous studies. This study aimed to evaluate whether peritonitis has a negative impact on mortality in a large cohort of peritoneal dialysis patients. We also assessed the changing impact of peritonitis on patient mortality with respect to duration of follow-up. METHODS: This retrospective cohort study included incident patients who started peritoneal dialysis from 1 January 2006 to 31 December 2011. Episodes of peritonitis were recorded at the time of onset, and peritonitis was parameterized as a time-dependent variable for analysis. We used the Cox regression model to assess whether peritonitis has a negative impact on mortality. RESULTS: A total of 1321 patients were included. The mean age was 48.1 ± 15.3 years, 41.3% were female, and 23.5% with diabetes mellitus. The median (interquartile) follow-up time was 34 (21–48) months. After adjusting for confounders, peritonitis was independently associated with 95% increased risk of all-cause mortality (hazard ratio, 1.95; 95% confidence interval: 1.46–2.60), 90% increased risk of cardiovascular mortality (hazard ratio, 1.90; 95% confidence interval: 1.28–2.81) and near 4-fold increased risk of infection-related mortality (hazard ratio, 4.94; 95% confidence interval: 2.47–9.86). Further analyses showed that peritonitis was not significantly associated with mortality within 2 years of peritoneal dialysis initiation, but strongly influenced mortality in patients dialysed longer than 2 years. CONCLUSIONS: Peritonitis was independently associated with higher risk of all-cause, cardiovascular and infection-related mortality in peritoneal dialysis patients, and its impact on mortality was more significant in patients with longer peritoneal dialysis duration. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-017-0588-4) contains supplementary material, which is available to authorized users. BioMed Central 2017-06-05 /pmc/articles/PMC5460447/ /pubmed/28583107 http://dx.doi.org/10.1186/s12882-017-0588-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ye, Hongjian
Zhou, Qian
Fan, Li
Guo, Qunying
Mao, Haiping
Huang, Fengxian
Yu, Xueqing
Yang, Xiao
The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients
title The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients
title_full The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients
title_fullStr The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients
title_full_unstemmed The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients
title_short The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients
title_sort impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460447/
https://www.ncbi.nlm.nih.gov/pubmed/28583107
http://dx.doi.org/10.1186/s12882-017-0588-4
work_keys_str_mv AT yehongjian theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT zhouqian theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT fanli theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT guoqunying theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT maohaiping theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT huangfengxian theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT yuxueqing theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT yangxiao theimpactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT yehongjian impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT zhouqian impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT fanli impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT guoqunying impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT maohaiping impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT huangfengxian impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT yuxueqing impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients
AT yangxiao impactofperitonealdialysisrelatedperitonitisonmortalityinperitonealdialysispatients