Objective: To analyze the risk factors for early-onset peritoneal dialysis-associated peritonitis (PDAP).
Methods: We selected 143 patients who underwent peritoneal dialysis (PD) catheter insertion in Nephrology Center, the First Affiliated Hospital of Zhengzhou University from 2011 to 2015 and had PDAP as the subjects and divided them into the early-onset PDAP group (first onset of PDAP within 3 months after PD) and late-onset PDAP group (first onset of PDAP after 3 months of PD) based on the first onset time of PDAP. We collected the general data of the patients, including sex, age, BMI, educational attainment, incidence rate of hypertension, diabetes and catheter exit-site infection, and frequency of PDAP. Laboratory indicators, such as serum hemoglobin, creatinine, potassium, calcium and albumin, total cholesterol, and triacylglycerol were measured and etiological examination was performed in the patients. The glomerular filtration rate (GFR) was estimated. And the prognosis was predicted. Risk factors for early-onset PDAP was analyzed with multiple stepwise Logistic regression.
Results: Of the 463 patients with PD, PDAP occurred in 143 (30.9%) for a total of 201 times. Early-onset PDAP occurred in 31 of the 143 patients, and late-onset PDAP occurred in 112. The differences in terms of sex, age, BMI and incidence rate of catheter exit-site infection between the two groups were statistically significant (P ＜ 0.05), while those in educational attainment, incidences of hypertension and diabetes and frequency of PDAP were not (P ＞ 0.05). There were no significant differences in the serum hemoglobin, creatinine, calcium, total cholesterol, and triacylglycerol levels and incidence of kaliopenia between the two groups (P ＞ 0.05). Notable differences were observed in the serum albumin level and estimated glomerular filtration rate (eGFR) between the two groups (P ＜ 0.05). No distinct differences existed in the results of etiological examination between the two groups (P ＞ 0.05). The treatment outcome of the early-onset PDAP group did not differ remarkably from that of the late-onset PDAP group (P ＞ 0.05). Results of multiple stepwise Logistic regression analysis revealed that male (OR=4.838, 95% CI (1.591, 14.707), P=0.005), higher BMI (OR=6.823, 95% CI (1.815, 25.648), P=0.004), catheter exit-site infection (OR=6.234, 95% CI (1.638, 23.730), P=0.007) and hypoalbuminemia (OR=1.027, 95% CI (1.006, 1.186), P=0.015) were risk factors independently associated with early-onset PDAP.
Conclusion: Male, higher BMI, catheter exit-site infection and hypoalbuminemia were the risk factors independently associated with early-onset PDAP.