Farias M G, Soucie J M, McClellan W, Mitch W E
Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia.
Kidney Int. 1994 Nov;46(5):1392-6. doi: 10.1038/ki.1994.410.
To study how clinical characteristics influence the risk of peritonitis in African American patients with end-stage renal disease treated with continuous ambulatory peritoneal dialysis (CAPD), we examined the risk of developing a first episode of peritonitis among 1,595 new dialysis patients initially treated by CAPD over a two year period in North Carolina, South Carolina, and Georgia (Network 6). Characteristics examined were demographic and socioeconomic factors, functional status, serum albumin and comorbid conditions. There were 538 initial episodes of peritonitis during an average of 8.8 patient months of follow-up; the time to peritonitis for the entire cohort was 26 months. Factors found to be independently associated with a risk for peritonitis were student status (Odds Ratio and 95% Confidence Interval = 2.4; 1.4 to 4.3), rental housing (1.2; 1.0 to 1.5), and substance abuse (1.9; 1.1 to 3.2). African Americans were 60% more likely to have an initial episode of peritonitis during follow-up than whites (1.6; 1.3 to 1.8). The time to the initial episode was 21 months for African Americans versus 32 months for whites (P < 0.001). Even after adjusting for other factors, African Americans were significantly more likely to develop peritonitis (1.5; 1.2 to 1.8). Thus, the increased risk of peritonitis of African American patients treated by CAPD is independent of other demographic, socioeconomic and comorbid characteristics.
为研究临床特征如何影响接受持续性非卧床腹膜透析（CAPD）治疗的终末期肾病非裔美国患者发生腹膜炎的风险，我们调查了北卡罗来纳州、南卡罗来纳州和佐治亚州（第6医疗网络）1595例最初接受CAPD治疗的新透析患者在两年期间发生首次腹膜炎的风险。所调查的特征包括人口统计学和社会经济因素、功能状态、血清白蛋白及合并症。在平均8.8个患者月的随访期间共发生538例初始腹膜炎事件；整个队列发生腹膜炎的时间为26个月。发现与腹膜炎风险独立相关的因素有学生身份（比值比及95%置信区间=2.4；1.4至4.3）、租房居住（1.2；1.0至1.5）及药物滥用（1.9；1.1至3.2）。非裔美国人在随访期间发生初始腹膜炎事件的可能性比白人高60%（1.6；1.3至1.8）。非裔美国人发生初始事件的时间为21个月，而白人为32个月（P<0.001）。即使对其他因素进行校正后，非裔美国人发生腹膜炎的可能性仍显著更高（1.5；1.2至1.8）。因此，接受CAPD治疗的非裔美国患者发生腹膜炎风险增加独立于其他人口统计学、社会经济及合并症特征。
