ABSTRACT
BACKGROUND: Early onset peritonitis (EOP) is not uncommon in peritoneal dialysis patients. We aimed to compare the prognosis of EOP and non-EOP peritoneal dialysis patients. METHODS: This study included subjects that underwent PD from January 1, 2004 to July 31, 2013. Patient characteristics were collected. EOP was defined as peritonitis occurring within 6 months after initiation of PD. Patient and technique survival were compared between EOP and non-EOP patients using Cox regression analyses. RESULTS: In total, 189 subjects were included in this study. Patients were divided into EOP (n = 55) and non-EOP groups (n = 134). There was no significant difference in the causative organisms of peritonitis between the two groups. After adjusting for age, diabetes status, serum albumin level and residual renal function, the multivariable Cox regression model revealed that EOP was an independent risk factor for patient mortality (HR 2.03, RI 1.09-3.80, p = 0.026), technique failure (HR 1.69, RI 1.12-2.87, p = 0.015) and total survival (HR 1.73, RI 1.12-2.68, p = 0.013). CONCLUSIONS: EOP was identified as an independent risk factor for mortality and technique failure in peritoneal dialysis patients.
ABSTRACT
BACKGROUND: Epidemiological studies have shown that hyperuricemia is associated with all-cause and cardiovascular mortality in chronic kidney disease (CKD) and hemodialysis patients. Our study investigated the influence of serum uric acid (UA) levels on survival in peritoneal dialysis (PD) patients. METHODS: This was a retrospective study involving 156 subjects who had undergone PD. The patient demographics, etiology of ESRD, comorbid conditions and other laboratory parameters were collected. The subjects were divided into three groups according to their serum UA concentrations (group 1, the lowest quartile; group 2, the middle quartiles; group 3, the highest quartile). The risk of death was calculated using a multivariate Cox regression model. RESULTS: There were 41 deaths during a follow-up period of 31.3±17.5 months. Compared with group 2, which had a mortality rate of 5.7 per 1000 person-months, the mortality rates were higher in group 1 (14.3 per 1000 person-months, p<0.05) and group 3 (13.3 per 1000 person-months, p<0.05). A multivariable Cox regression model revealed that age, serum albumin, diabetes mellitus (DM), hypertensive nephropathy, residual renal function and UA group were factors associated with mortality in the PD patients. Using group 2 as a reference, the hazard ratio (HR) of mortality was found to be 1.15 (95% confidence interval [CI] 0.20-2.57, p>0.05) for group 1 and 2.96 (95% CI 1.29-6.80, p=0.01) for group 3. CONCLUSIONS: In PD patients, a higher serum UA level is related to increased mortality and is an independent risk factor for all-cause mortality. Uric acid levels and all-cause mortality in peritoneal dialysis patients.
