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Relationship between initial peritoneal dialysis modality and risk of peritonitis
Maiko Kokubu1, Masaru Matsui2, Takayuki Uemura1
1Department of Nephrology, Nara Prefecture General Medical Center, 2-897-5 Shichijo-nishimachi, Nara, 630-8581, Japan.
Scientific Reports
|October 31, 2020
Summary
Automated peritoneal dialysis (APD) significantly reduces peritonitis risk compared to continuous ambulatory peritoneal dialysis (CAPD) in patients starting peritoneal dialysis (PD). This finding suggests APD may be a preferred method for preventing peritonitis in PD patients.
Area of Science:
- Nephrology
- Internal Medicine
- Medical Technology
Background:
- Peritonitis is a serious complication of peritoneal dialysis (PD).
- Previous studies on peritonitis risk between continuous ambulatory PD (CAPD) and automated PD (APD) lacked detailed connection type analysis.
- Understanding the relationship between PD modality and peritonitis risk is crucial.
Purpose of the Study:
- To compare the risk of peritonitis in patients initiated on APD versus CAPD.
- To investigate the influence of connection type on peritonitis risk in PD patients.
Main Methods:
- A retrospective study of 285 patients initiating PD between 1997 and 2014.
- Propensity score matching created a cohort of 106 APD patients and 106 CAPD patients.
- Time to first peritonitis episode within 3 years was the primary outcome, analyzed using adjusted models and inverse probability of treatment weighting.
Main Results:
- Patients initiated on APD showed a significantly lower risk of peritonitis compared to CAPD patients.
- The fully adjusted hazard ratio (HR) for peritonitis in APD vs. CAPD was 0.30 (95% CI 0.17-0.53).
- Matched cohort analysis (HR 0.32) and inverse probability weighting (HR 0.35) confirmed these findings.
Conclusions:
- Initiating PD with APD is associated with a reduced risk of peritonitis.
- APD may be a preferable modality for peritonitis prevention in peritoneal dialysis patients.
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