Kerschbaum Julia, König Paul, Rudnicki Michael
Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
Int J Nephrol. 2012;2012:483250. doi: 10.1155/2012/483250. Epub 2012 Dec 20.
Background. Peritonitis represents a major complication of peritoneal dialysis (PD). The aim of this paper was to systematically collect data on patient-related risk factors for PD-associated peritonitis, to analyze the methodological quality of these studies, and to summarize published evidence on the particular risk factors. Methods. Studies were identified by searches of Pubmed (1990-2012) and assessed for methodological quality by using a modified form of the STROBE criteria. Results. Thirty-five methodologically acceptable studies were identified. The following nonmodifiable risk factors were considered valid and were associated with an increased risk of peritonitis: ethnicity, female gender, chronic lung disease, coronary artery disease, congestive heart failure, cardiovascular disease, hypertension, antihepatitis C virus antibody positivity, diabetes mellitus, lupus nephritis or glomerulonephritis as underlying renal disease, and no residual renal function. We also identified the following modifiable, valid risk factors for peritonitis: malnutrition, overweight, smoking, immunosuppression, no use of oral active vitamin D, psychosocial factors, low socioeconomic status, PD against patient's choice, and haemodialysis as former modality. Discussion. Modifiable and nonmodifiable risk factors analyzed in this paper might serve as a basis to improve patient care in peritoneal dialysis.
背景。腹膜炎是腹膜透析（PD）的主要并发症。本文旨在系统收集与腹膜透析相关腹膜炎患者相关危险因素的数据，分析这些研究的方法学质量，并总结关于特定危险因素的已发表证据。方法。通过检索Pubmed（1990 - 2012年）确定研究，并使用改良版的STROBE标准评估方法学质量。结果。确定了35项方法学上可接受的研究。以下不可改变的危险因素被认为是有效的，且与腹膜炎风险增加相关：种族、女性、慢性肺病、冠状动脉疾病、充血性心力衰竭、心血管疾病、高血压、抗丙型肝炎病毒抗体阳性、糖尿病、潜在肾病为狼疮性肾炎或肾小球肾炎以及无残余肾功能。我们还确定了以下可改变的、有效的腹膜炎危险因素：营养不良、超重、吸烟、免疫抑制、未使用口服活性维生素D、社会心理因素、社会经济地位低、违背患者意愿进行腹膜透析以及既往接受血液透析治疗。讨论。本文分析的可改变和不可改变的危险因素可能为改善腹膜透析患者护理提供依据。
