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Membrane transport status does not predict peritonitis risk in patients on peritoneal dialysis
Author(s) -
So Sarah,
Aw Laraine,
Sud Kamal,
Lee Vincent W.
Publication year - 2018
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13063
Subject(s) - medicine , peritoneal dialysis , peritonitis , hazard ratio , surgery , gastroenterology , retrospective cohort study , proportional hazards model , confidence interval
Aim The aim of this study is to determine whether peritoneal membrane transport status (MTS) is associated with peritonitis or poor peritoneal dialysis‐related outcomes. Methods This retrospective cohort study analysed data of incident adult patients on peritoneal dialysis in Western Sydney between 1 October 2003 and 31 December 2012. Only patients who underwent peritoneal equilibration and adequacy tests within 6 months of commencement were included. Kaplan–Meier survival curves for time until first peritonitis and time until composite endpoint of peritonitis, death or technique failure, censored for transplant, were constructed. Results About 397 patients, mean age 58.8(+/−2SD29) years, body mass index (BMI) 26.6(+/−5) kg/m 2 and serum albumin 35.4(+/−5) g/L were included. About 59.2% had high/high‐average peritoneal MTS; 45.8% were past and current smokers; 51.9% developed at least one episode of peritonitis; 7.6% changed to haemodialysis; 6.3% underwent transplantation; 8.8% died; and 25.4% remained free of the aforementioned events over a mean follow‐up period of 22.5 months (range 0–115 months). Peritoneal MTS was not associated with time to first peritonitis ( p = 0.67) or composite endpoint of peritonitis, death or technique failure ( p = 0.12). Smoking and hypoalbuminaemia independently predicted time to first peritonitis. Past and current smokers had a hazard ratio of 1.38 (95% CI 1.03–1.86) for shorter time to first peritonitis, significant after adjustment for serum albumin ( p = 0.033). Serum albumin <32 g/L had a hazard ratio of 1.74 (95% CI 1.13–2.67) for shorter time to first peritonitis, significant after adjusting for smoking ( p = 0.012). Conclusion Smoking and hypoalbuminaemia, but not MTS, were associated with shorter time to first peritonitis and composite endpoint of peritonitis, death and technique failure.