Development and validation of a nomogram for predicting refractory peritoneal dialysis related peritonitis

Qiqi Yan ^1,2, Guiling Liu ^1,2, Ruifeng Wang ^1,2

⁰Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

Renal Failure +

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July 3, 2024

View abstract on PubMed

Summary

This study identified key risk factors for refractory peritoneal dialysis-related peritonitis (PDRP) and developed a nomogram to predict its occurrence. The nomogram demonstrates good accuracy in predicting PDRP in patients undergoing peritoneal dialysis (PD).

Area Of Science

Nephrology
Clinical Epidemiology
Medical Statistics

Background

Peritonitis is a common complication of peritoneal dialysis (PD).
Refractory peritonitis, defined by persistent cloudy effluent or high leukocyte counts after 5 days of antibiotics, poses a significant challenge in PD management.
Identifying risk factors and developing predictive tools for refractory peritonitis are crucial for improving patient outcomes.

Purpose Of The Study

To identify risk factors associated with refractory peritoneal dialysis-related peritonitis (PDRP).
To construct and validate a nomogram for predicting the occurrence of refractory PDRP in PD patients.

Main Methods

A dataset of 294 peritonitis episodes in 178 PD patients was analyzed.
Risk factors were identified using univariate and LASSO logistic regression, and random forest algorithms.
A nomogram was constructed using independent risk factors and validated for discriminative and calibration abilities.

Main Results

Refractory peritonitis occurred in 93 episodes.
Independent risk factors for PDRP included C-reactive protein, serum albumin, diabetes mellitus, PD duration, and causative organisms.
The nomogram showed excellent discrimination (AUC 0.781 in training, 0.741 in validation) and satisfactory calibration.

Conclusions

The developed nomogram accurately predicts refractory peritonitis in patients undergoing PD.
This predictive tool can aid clinicians in managing PD-related peritonitis and potentially prevent refractory cases.

Keywords:

Nomogram peritoneal dialysis peritonitis refractory peritonitis