Association between the use of exchange devices for peritoneal dialysis fluids and peritonitis incidence: A nationwide cohort study

Author:

Hasegawa Takeshi1234ORCID,Noma Hisashi5,Hamano Takayuki6,Abe Masanori7,Wada Atsushi8,Honda Hirokazu2,Ito Yasuhiko9,Masakane Ikuto10,Nitta Kosaku11

Affiliation:

1. Showa University Research Administration Center (SURAC), Showa University, Tokyo, Japan

2. Division of Nephrology, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan

3. Department of Hygiene, Public Health and Preventive Medicine, Graduate School of Medicine, Showa University, Tokyo, Japan

4. Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Japan

5. Department of Statistical Data Science, The Institute of Statistical Mathematics, Tokyo, Japan

6. Department of Nephrology, Nagoya City University Graduate School of Medical Sciences, Japan

7. Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan

8. Kitasaito Hospital, Asahikawa, Japan

9. Division of Nephrology and Rheumatology, Aichi Medical University, Japan

10. Division of Nephrology, Motomachi Yabuki Clinic, Yamagata, Japan

11. Kidney Center, Department of Medicine, Tokyo Women’s Medical University, Japan

Abstract

Background: The use of exchange devices for peritoneal dialysis (PD) fluids is a common practice in Japan. Evidence on the effectiveness of exchange devices in preventing PD-related peritonitis is scarce. We evaluated the association between the use of exchange devices for PD fluids and peritonitis incidence. Methods: We retrospectively enrolled 3845 patients, aged ≥20 years, receiving PD for ≥3 months, with available data on the exchange procedure for PD fluids and peritonitis incidence that was obtained from the Japan Renal Data Registry, a nationwide annual survey. The patients were grouped according to whether the manual or device PD fluid exchange method was used. The onset of peritonitis was defined as a leukocyte count of >100/µL (neutrophils ≥50%) in PD effluents. We applied quasi-Poisson regression analyses to estimate the incidence rate ratio (IRR). Age, sex, PD vintage, body mass index, automated PD use, residual kidney function, comorbidities, haemoglobin and serum albumin were adjusted as potential confounders. Results: Older age, automated PD use, diabetes as comorbidity and lower haemoglobin levels were associated with the use of exchange devices for PD fluids. Patients using devices for PD fluid exchange (69.2%) had an increased risk of peritonitis of 37% (IRR: 1.37, 95% confidence interval (CI): 1.07–1.75) and 28% (IRR: 1.28, 95% CI: 1.00–1.63) in the crude and multivariate adjustment models, respectively. Conclusions: The use of exchange devices for PD fluids and peritonitis incidence showed no favourable association. There may remain possible residual confounding by indication.

Publisher

SAGE Publications

Subject

Nephrology,General Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Peritoneal dialysis-related infections in elderly patients;Clinical and Experimental Nephrology;2024-06-25

2. 6.PD;Nihon Toseki Igakkai Zasshi;2022

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