Risk factors for peritoneal dialysis–associated peritonitis

Abstract

The purpose of this study was to summarize the pathogens that cause peritoneal dialysis (PD)-associated peritonitis and to identify risk factors for PD-associated peritonitis. This retrospective study included 115 end-stage renal disease (ESRD) patients receiving PD therapy. Patients were categorized into two groups: peritonitis group (n = 41) and non-peritonitis group (n = 74). Clinical data and laboratory tests were collected from medical records. The multivariate logistic regression model was used to evaluate associations between PD-associated peritonitis and potential risk factors. PD-associated peritonitis occurred 54 times in 41 patients. The most frequently identified pathogen was Gram-positive cocci (57.78%). Multivariate logistic regression analysis showed that serum albumin (β = –0.208, P < 0.001), blood phosphorus concentration (β = –1.732, P = 0.001), gastrointestinal disorders (β = 1.624, P = 0.043), and use of calcitriol (β = –2.239, P = 0.048) were significantly correlated with PD-associated peritonitis. Receiver operating characteristic (ROC) curves showed that the areas under the curve were 0.832 for serum albumin and 0.700 for blood phosphorus concentration with optimal cut-off values of 29.1 g/L for serum albumin and 1.795 mmol/L for blood phosphorus concentration. Gram-positive coccus is the major pathogen responsible for PD-associated peritonitis. Serum albumin <29.1 g/L, blood phosphorus concentration <1.795 mmol/L, and intestinal disorders are risk factors for PD-associated peritonitis, whereas the use of calcitriol can reduce the risk of PD-associated peritonitis.