PMID- 15981776
OWN - NLM
STAT- MEDLINE
DCOM- 20051013
LR  - 20220317
IS  - 0896-8608 (Print)
IS  - 0896-8608 (Linking)
VI  - 25
IP  - 3
DP  - 2005 May-Jun
TI  - Peritonitis-related mortality in patients undergoing chronic peritoneal dialysis.
PG  - 274-84
AB  - Peritonitis is a well-known cause of mortality in peritoneal dialysis (PD) 
      patients. We carried out a retrospective study to disclose the clinical spectrum 
      and risk profile of peritonitis-related mortality. We analyzed 693 episodes of 
      infectious peritonitis suffered by 565 patients (follow-up 1149 patient-years). 
      Death was the final outcome in 41 cases (5.9% of episodes), peritonitis being 
      directly implicated in 15.2% of the global mortality and 68.5% of the infectious 
      mortality observed. In 41.5% of patients with peritonitis-related mortality, the 
      immediate cause of death was a cardiovascular event. Highest mortality rates 
      corresponded to fungal (27.5%), enteric (19.3%), and Staphylococcus aureus 
      (15.2%) peritonitis. Multivariate analysis disclosed thatthe baseline risk of 
      peritonitis-related mortality was significantly higher in female [relative risk 
      (RR) 2.13, 95% confidence interval (CI) 1.24-4.09, p = 0.02], older (RR 
      1.10/year, CI 1.06-1.14, p < 0.0005), and malnourished patients (RR 2.51, CI 
      1.21-5.23, p = 0.01) with high serum C-reactive protein (s-CRP) levels (RR 4.04, 
      CI 1.45-11.32, p = 0.008) and a low glomerular filtration rate (RR 0.75 per 
      mL/minute, CI 0.64 -0.87, p < 0.0005). Analysis of risk after a single episode of 
      peritonitis and/or subanalysis restricted to peritonitis caused by more 
      aggressive micro-organisms disclosed that overall comorbidity [odds ratio (OR) 
      1.21, CI 1.05-1.71, p = 0.005], depression (OR 2.35, CI 1.14-4.84, p = 0.02), and 
      time on PD at the time of the event (OR 1.02/month, CI 1.00-1.03, p = 0.02) were 
      other predictors of mortality. In summary, the etiologic agent is a definite 
      marker of peritonitis-related mortality but gender, age, residual renal function, 
      inflammation (s-CRP), malnutrition, and depression are other significant 
      correlates of this outcome. Most of these risk factors are common to 
      cardiovascular and peritonitis-related mortality, which may explain the high 
      incidence of cardiovascular event as the immediate cause of death in patients 
      with peritonitis-related mortality.
FAU - Perez Fontan, Miguel
AU  - Perez Fontan M
AD  - Division of Nephrology, Hospital Juan Canalejo, University of A Coruna, A Coruna, 
      Spain. mfontan@canalejo.org
FAU - Rodriguez-Carmona, Ana
AU  - Rodriguez-Carmona A
FAU - Garcia-Naveiro, Rafael
AU  - Garcia-Naveiro R
FAU - Rosales, Miguel
AU  - Rosales M
FAU - Villaverde, Pedro
AU  - Villaverde P
FAU - Valdes, Francisco
AU  - Valdes F
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Perit Dial Int
JT  - Peritoneal dialysis international : journal of the International Society for 
      Peritoneal Dialysis
JID - 8904033
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Child
MH  - Female
MH  - Follow-Up Studies
MH  - Gram-Negative Bacterial Infections/epidemiology/etiology/*mortality
MH  - Gram-Positive Bacterial Infections/epidemiology/etiology/*mortality
MH  - Humans
MH  - Incidence
MH  - Kidney Failure, Chronic/*therapy
MH  - Male
MH  - Middle Aged
MH  - Mycoses/epidemiology/etiology/*mortality
MH  - Peritoneal Dialysis/*adverse effects
MH  - Peritonitis/epidemiology/microbiology/*mortality
MH  - Risk Factors
EDAT- 2005/06/29 09:00
MHDA- 2005/10/14 09:00
CRDT- 2005/06/29 09:00
PHST- 2005/06/29 09:00 [pubmed]
PHST- 2005/10/14 09:00 [medline]
PHST- 2005/06/29 09:00 [entrez]
PST - ppublish
SO  - Perit Dial Int. 2005 May-Jun;25(3):274-84.