Kidney Res Clin Pract.  2020 Dec;39(4):460-468. 10.23876/j.krcp.20.069.

Clinical outcomes of infection-related hospitalization in incident peritoneal dialysis patients

• Jeon Y
• Kim HD
• Hong YA
• Kim HW
• Yang CW
• Chang YK
• Kim YK

• KMID: 2509807
• DOI: http://doi.org/10.23876/j.krcp.20.069

Abstract

Background
Infection is the second leading cause of death in patients undergoing long-term dialysis. Peritoneal dialysis (PD) is associated with an increased risk of infection-related hospitalization (IRH) when compared with hemodialysis. In this study, we investigated the influence of IRH on clinical outcomes in incident PD patients.
Methods
In total, 583 incident PD patients were selected from the Clinical Research Center Registry for End-Stage Renal Disease, a nationwide multicenter prospective observational cohort study in Korea. Incident PD patients who had been hospitalized for infection-related diseases were defined as the IRH group. The primary outcome was all-cause mortality and the secondary outcome was technical failure. The median follow-up period was 29 months.
Results
Seventy-three PD patients (12.5%) were categorized in the IRH group. Multivariable logistic regression analysis showed that diabetes mellitus was a significant independent predictor for IRH (odds ratio, 2.43; 95% confidence interval [CI], 1.12 to 5.29; P = 0.007). The most common causes of IRH were peritonitis (63.0%) and respiratory tract infection (9.6%). Multivariable Cox proportional hazard model analysis showed that IRH was a significant independent risk factor for all-cause mortality (hazard ratio [HR], 2.51; 95% CI, 1.12 to 5.62; P = 0.026) and for the technical failure of PD (HR, 3.23; 95% CI, 1.90 to 5.51; P < 0.001).
Conclusion
Our data showed that after initiation of PD, IRH was significantly associated with higher risk of all-cause mortality and technical failure.

Keyword

Hospitalization; Infections; Mortality; Peritoneal dialysis; Peritonitis