Risk Factors for Peritonitis in Patients With Systemic Lupus Erythematosus Undergoing Peritoneal Dialysis.

Area of Science:

• Nephrology
• Rheumatology
• Infectious Disease

Background:

• Limited data exists on medication regimens for infection-prone patients with Systemic Lupus Erythematosus (SLE) undergoing Peritoneal Dialysis (PD).
• Peritonitis is a significant complication for patients on PD, especially those with underlying conditions like SLE.

Purpose of the Study:

• To evaluate the association between medication use and peritonitis risk in SLE patients on PD.
• To compare peritonitis rates between SLE patients and non-SLE controls undergoing PD.

Main Methods:

• Retrospective study of PD patients from 2007-2023.
• Propensity score matching compared 46 SLE patients with 46 non-SLE controls.
• Poisson regression and time-dependent Cox proportional hazards models analyzed peritonitis incidence and risk factors.

Main Results:

• Peritonitis incidence was higher in SLE patients (0.32 episodes/patient-year) versus controls (0.25 episodes/patient-year).
• Independent peritonitis risk factors in SLE patients included male sex, gastric acid suppressants (GAS), and glucocorticoids (GC).
• Outcomes like time to first peritonitis, catheter removal, and mortality were similar between groups.

Conclusions:

• Peritoneal Dialysis (PD) is a safe dialysis modality for Systemic Lupus Erythematosus (SLE) patients, with comparable outcomes to non-SLE controls.
• The risk of peritonitis in SLE patients on PD may be elevated by GAS, GC, and male sex.
• Further research into optimizing medication regimens for SLE patients on PD is warranted to mitigate peritonitis risk.