Risk factors associated with treatment failure in peritoneal dialysis-associated peritonitis

Area of Science:

• Nephrology
• Infectious Diseases
• Clinical Chemistry

Background:

• Peritonitis is a common complication of peritoneal dialysis (PD).
• Treatment failure in PD-associated peritonitis (PDAP) can lead to severe outcomes.
• Identifying risk factors for PDAP treatment failure is crucial for timely intervention.

Purpose of the Study:

• To identify clinical and laboratory factors associated with treatment failure in PDAP.
• To enable earlier identification of high-risk patients.
• To improve clinical management strategies for PDAP.

Main Methods:

• Retrospective study of PDAP episodes at a tertiary hospital.
• Classification of PDAP episodes into treatment success or failure groups.
• Analysis using LASSO and GEE logistic regression to identify risk factors.
• Receiver operating characteristic (ROC) curve analysis to assess predictive performance.

Main Results:

• Out of 103 PDAP episodes, 32 (31.07%) resulted in treatment failure.
• Elevated D-dimer, SIRI (Systemic Inflammatory Response Index), and serum phosphorus were independent risk factors for PDAP treatment failure.
• D-dimer demonstrated the highest predictive performance (AUC=0.76) for treatment failure.

Conclusions:

• Elevated D-dimer, SIRI, and serum phosphorus are significant predictors of PDAP treatment failure.
• D-dimer is a particularly strong predictor, suggesting its utility in risk stratification.
• These findings can guide clinical decision-making for PDAP management.