Nessim Sharon J, Bargman Joanne M, Austin Peter C, Nisenbaum Rosane, Jassal Sarbjit V
Department of Medicine, Division of Nephrology, St. Michael's Hospital, Toronto, Ontario, Canada.
Clin J Am Soc Nephrol. 2009 Jul;4(7):1195-200. doi: 10.2215/CJN.00910209. Epub 2009 Apr 30.
Despite the decreasing incidence of peritonitis among peritoneal dialysis (PD) patients over time, its occurrence is still associated with significant morbidity and mortality. Determining factors that are associated with PD peritonitis may facilitate the identification of patients who are at risk.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data collected in the multicenter Baxter POET database between 1996 and 2005, the study population included incident Canadian PD patients. Potential predictors of peritonitis were sought using a negative binomial model and an Andersen-Gill model. Study variables included age, gender, race, cause of renal disease, diabetes status, transfer from hemodialysis (HD), previous renal transplant, and continuous ambulatory PD (CAPD) versus automated PD (APD).
Data were available for 4247 incident PD patients, including 1605 patients with a total of 2555 peritonitis episodes. Using the negative binomial regression model, factors that were independently associated with a higher peritonitis rate included age, Black race, and having transferred from HD. There was an interaction between gender and diabetes, with an increased risk for peritonitis among female patients with diabetes. The use of CAPD versus APD did not affect the peritonitis rate. The Andersen-Gill model for recurrent events yielded similar results.
Predictors of PD peritonitis included Black race, transferring from HD to PD, and diabetes among women. In contrast to previous findings, CAPD and APD were similar with regard to peritonitis risk.
尽管随着时间推移，腹膜透析（PD）患者腹膜炎的发病率有所下降，但其发生仍与显著的发病率和死亡率相关。确定与PD腹膜炎相关的因素可能有助于识别有风险的患者。
设计、地点、参与者与测量：利用1996年至2005年在多中心百特POET数据库中收集的数据，研究人群包括加拿大初治PD患者。使用负二项模型和安德森-吉尔模型寻找腹膜炎的潜在预测因素。研究变量包括年龄、性别、种族、肾病病因、糖尿病状态、从血液透析（HD）转来、既往肾移植以及持续非卧床腹膜透析（CAPD）与自动化腹膜透析（APD）。
有4247例初治PD患者的数据，其中1605例患者共发生2555次腹膜炎发作。使用负二项回归模型，与较高腹膜炎发生率独立相关的因素包括年龄、黑人种族以及从HD转来。性别与糖尿病之间存在交互作用，糖尿病女性患者腹膜炎风险增加。CAPD与APD的使用对腹膜炎发生率无影响。针对复发事件的安德森-吉尔模型得出了类似结果。
PD腹膜炎的预测因素包括黑人种族、从HD转为PD以及女性糖尿病患者。与既往研究结果不同，CAPD和APD在腹膜炎风险方面相似。
