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Predictors of Peritoneal Dialysis Associated Peritonitis; Application of the Zero-Inflated Negative Binomial Model Publisher



Jahromi SE1 ; Ahmed F2 ; Pourahmad S3, 4, 5 ; Roozbeh J1 ; Najafi I6 ; Ebrahimi V1, 4, 5
Authors
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Authors Affiliations
  1. 1. Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2. Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Bioinformatics and Computational Biology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  4. 4. Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  5. 5. Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  6. 6. Department of Nephrology, Tehran University of Medical Sciences, Shiraz, Iran

Source: Journal of Nephropathology Published:2019


Abstract

Introduction: Peritonitis is the main cause of morbidity and dropout from peritoneal dialysis (PD) program. Objectives: We aimed to determine risk factors predisposing to PD-associated peritonitis. Patients and Methods: As a retrospective cohort research, on 235 PD individuals with 4277 patient-months of follow up, 170 episodes of peritonitis was reported in 93 patients. Data were extracted from medical records using a template. Standard as well as zero-inflated negative binominal regression was used to model the association between patients’ characteristics and the peritonitis rate. Cox-proportional hazard (PH) adjusted model was used to determine the effect of factors on the peritonitis-free survival. Results: With a mean (SD) body mass index (BMI) of 18.7(3.4) kg/m2, 109 (46.4%) of them were male. With a median (95% CI) follow-up time of 19 (16 to 36) months, the rate of peritonitis was 0.48 episode per patient-year. The most common micro-organism detected was coagulase-negative staphylococci (n=54; 31.7%). The only variable which was associated with a higher rate of peritonitis was BMI (rate ratio [RR]: 1.07; 95% CI 1.01 to 1.14; P value=0.031). Comparing to patients with lower education, patients with higher than elementary school of education had higher peritonitis-free survival (with hazard ratio [HR]=0.51; 95%CI 0.33-0.79, P value=0.003) and higher chance of having no peritonitis [odds ratio (OR):1.97; 95% CI 1.08 to 3.59; P value=0.029]. Conclusion: Peritonitis is still a major concern in PD patients. BMI was a risk factor for higher peritonitis rate. Higher education level was associated with lower peritonitis-free survival and higher chance of having no peritonitis. Conclusion: Peritonitis is still a major concern in PD patients. BMI was a risk factor for higher peritonitis rate. Higher education level was associated with lower peritonitis-free survival and higher chance of having no peritonitis. © 2019 The Author(s).
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