The changing trends of peritoneal dialysis related peritonitis and novel risk factors

Figures & data

Table 1. The demographical and clinical characteristics of the patients.

Patient characteristics	n (%)
Age (year)	46.3 ± 16.80
Female	202 (45.9)
Mean ESRD duration (year)	7.5 ± 4.62
Literacy
Illiterate	87 (19.8)
Primary School Graduate	183 (41.6)
High School Graduate	110 (25)
University Graduate	60 (13.6)
ESRD Etiology
Unknown	142 (32.3)
Glomerulonephritis	69 (15.7)
DM	65 (14.8)
HT	39 (8.9)
Vesicoureteral reflux	38 (8.6)
Amyloidosis	34 (7.7)
Nephrolithiasis	28 (6.4)
Polycystic kidney disease	25 (5.7)
Comorbidities
HT	296 (67.3)
DM	86 (19.5)
CAD	68 (15.5)
PAD	12 (2.7)
Cirrhosis	29 (6.6)
Prior HD	251 (57.2)
No prior HD, only PD	189 (42.8)
APD	59 (13.4)
At least one peritonitis episode	271 (61.6)
No peritonitis episode	169 (38.4)
Catheter related infection	60 (13.6)

ESRD (end stage renal disease), DM (diabetes mellitus), HT (Hypertension), CAD (coronary artery disease), PAD (peripheral artery disease), HD (hemodialysis), PD (peritoneal dialysis), APD (automated-peritoneal dialysis).

Table 2. The comparison of different models of peritonitis rates (2000–2006).

Cohort-specific peritonitis incidence	One episode per 19.3 patient-months or 0.62 episodes per patient-year
Median subject-specific peritonitis incidence**	One episode per 15.6 patient-months or 0.44 episodes per patient-year
Median peritonitis free survival*	15.25 months (%95 CI 9.45–21.06 months)

*Only new PD patients during the observation period were considered.

**Patients with at least 6 months observation time were considered.

Figure 1. Distribution of percentage of causative organisms between 2000–2003 and 2003–2006.

Table 3. Causative organisms and their percentages between the time periods.

	2000–2006		2000–2003		2003–2006
	Number of peritonitis	%	Number of peritonitis	%	Number of peritonitis	%	p-Value
Culture negative	305	49.2	200	53.1	105	43.2	0.017
Gram-positive
Micro-organisms
MSCoNS^a	106	17.1	70	18.6	36	14.8	0.226
MRCoNS^b	51	8.2	20	5.3	31	12.8	0.001
MSSA^c	32	5.2	22	5.8	10	4.1	0.345
Alfa hemolytic streptococci	15	2.4	8	2.1	7	2.9	0.548
Diphtheroid bacilli	11	1.8	7	1.9	4	1.6	0.846
Streptococcus pneumonia	6	1.0	4	1.1	2	0.8	0.768
MRSA^d	4	0.6	4	1.1	–	–	0.107
Enterococcus faecium	3	0.5	1	0.3	2	0.8	0.329
Gemella morbillorum	1	0.2	–	–	1	0.8	0.213
Aerococcus urinae	1	0.2	1	0,3	–	–	0.427
Streptococcus anginosus	1	0.2	–	–	1	0.8	0.213
Streptococcus intermedius	1	0.2	–	–	1	0.8	0.213
Streptococcus vestibularis	1	0.2	–	–	1	0.8	0.213
Total Gr(+)	233	37.6	137	36.3	96	39.5	0.427
Gram-negative
Micro-organisms
E. coli	37	6.0	9	2.4	28	11.5	0.000
P. auregunosa	16	2.6	13	3.4	3	1.2	0.090
Klebsiella pneumonia	7	1.1	3	0.8	4	1.6	0.328
Moraxella spp	6	1.0	4	1.1	2	0.8	0.768
Klebsiella oxytoca	3	0.5	3	0.8			0.163
Enterobacter cloacae	3	0.5	1	0.3	2	0.8	0.422
Acinetobacter spp	2	0.3	2	0.5	–	–	0.255
Morgonella morganii	1	0.2	–	–	1	0.4	0.213
Chromobacterium violaceum	1	0.2	1	0.3	–	–	0.422
Enterobacter aerogenes	1	0.2	1	0.3	–	–	0.422
Brucella spp	1	0.2	–	–	1	0.4	0.213
Proteus mirabilis	1	0.2	–	–	1	0.4	0.213
Total Gr(–)	79	12.7	37	9.8	42	17.3	0.001
OTHERS
Candida spp	3	0.5	3	0.8	–	–	0.163
TOTAL	620	100	377	100	243	100

Statistically significant p-values, total number and percentage of peritonitis, total number and percentages of Gram (+) and Gram (−) organisms were bolded.

^aMethicillin sensitive coagulase-negative Staphylococcus.

^bMethicillin resistant coagulase-negative Staphylococcus.

^cMethicillin sensitive S. aureus.

^dMethicillin resistant S. aureus.

Table 4. Logistic regression analysis of factors associated with peritonitis.

	Odds ratio	(95% CI) of developing peritonitis	p-Value
Prior HD therapy	1.76	1.06–2.93	0.029
Catheter related infection	4.05	1.81–9.06	0.001
HCV infection	2.84	1.36–5.91	0.005
Literacy	0.98	0.76–1.26	0.899
HBsAg	4.91	0.59–40.24	0.138

Statistically significant p-Values were bolded.