Risk Factors And Outcomes Of Early Peritonitis In Chinese Peritoneal Dialysis Patients

Aim:Study concerning risk factors and outcomes of peritonitis within first 6 months in peritoneal dialysis patients is sparse.This study aims to investigate risk factors associated with early-onset peritonitis(EOP)and its influence on patients' technique survival and mortality.Methods:This is a retrospective observational cohort study.A total of 483 patients who having at least one episode of peritonitis were the study subjects,followed up from March 1st,2002 to August 31,2016,in our center.According to the time to first peritonitis,we divided patients into two groups:EOP(?6 months,n=167)and late-onset peritonitis(LOP,>6 months,n=316).Logistic regression was used to analyze the factors associated with EOP.Cox proportional hazard model was conducted to examine the influence of EOP on clinical outcomes.Results:Of 483 patients,167(34.6%)patients developed the first episode of peritonitis within first 6 months.The multivariate logistic analysis showed that factors associated with EOP include male gender(odds ratio(OR)1.920,95%confidence interval(CI)1.272-2.897,p=0.002),and a low serum albumin level at the start of PD(OR 0.950,95%CI 0.914-0.986,p=0.007).In the Cox proportional hazard model,EOP was a significant predictor of all-cause mortality(hazard ratio(HR)2.766,95%CI 1.561-4.900,p<0.001).There were no differences between EOP and LOP for technique failure.However,in continuous analyses,a negative correlation was observed between time to first peritonitis and technique failure(HR 0.988,95%CI 0.980-0.997,p=0.006).In the Spearman analysis,time to first peritonitis was negatively correlated with peritonitis rate(r=-0.573,p<0.001).Conclusions:Male gender and a low serum albumin level before PD were strongly associated with an EOP.Also,an EOP patient had a higher risk of poor clinical outcomes.More importantly,an early peritonitis onset was associated with a high peritonitis rate.