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

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...

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Published in:	Kidney research and clinical practice Vol. 39; no. 4; pp. 460 - 468
Main Authors:	Jeon, Youngdong, Kim, Hyung Duk, Hong, Yu Ah, Kim, Hyung Wook, Yang, Chul Woo, Chang, Yoon-Kyung, Kim, Yong Kyun
Format:	Journal Article
Language:	English
Published:	Korea (South) Korean Society of Nephrology 01-12-2020 The Korean Society of Nephrology 대한신장학회
Subjects:	hospitalization infections mortality Original peritoneal dialysis peritonitis 내과학 Hospitalization Infections Mortality Peritoneal dialysis Peritonitis
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Summary:	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. 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. 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). Our data showed that after initiation of PD, IRH was significantly associated with higher risk of all-cause mortality and technical failure.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Editor: Sejoong Kim, Seoul National University, Seongnam, Republic of Korea
ISSN:	2211-9132 2211-9140
DOI:	10.23876/j.krcp.20.069