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Original ArticlesESRD and Chronic Dialysis
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The Association between Peritoneal Dialysis Modality and Peritonitis

Patrick G. Lan, David W. Johnson, Stephen P. McDonald, Neil Boudville, Monique Borlace, Sunil V. Badve, Kamal Sud and Philip A. Clayton
CJASN June 2014, 9 (6) 1091-1097; DOI: https://doi.org/10.2215/CJN.09730913
Patrick G. Lan
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David W. Johnson
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Stephen P. McDonald
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Neil Boudville
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Monique Borlace
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Sunil V. Badve
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Kamal Sud
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Philip A. Clayton
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    Figure 1.

    APD use over time: the proportion of incident Australian PD patients using APD according to time spent on PD during the period from 2003 to 2011. APD, automated peritoneal dialysis; CAPD, continuous ambulatory peritoneal dialysis; PD, peritoneal dialysis.

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    Figure 2.

    Association between APD (versus CAPD) and peritonitis-associated outcomes in incident Australian PD patients during the period from 2003 to 2011. All estimates are adjusted for previous RRT before PD, age, race, body mass index, diabetes mellitus, coronary artery disease, cigarette smoking, and cerebrovascular disease. Outcome of first infection also adjusted for organism. 95% CI, 95% confidence interval; HD, hemodialysis; HR, hazard ratio; IRR, incidence rate ratio; OR, odds ratio.

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    Table 1.

    Characteristics of patients commencing PD, according to APD exposure

    FactorCAPD GroupAPD GroupP Value
    Patients (n)27614198
    RRT before PD992 (35.9)1603 (38.2)0.06
    Age at PD start (yr)64.0 (52.0, 73.0)60.0 (48.0, 70.0)<0.001
    Men1508 (54.6)2506 (59.7)<0.001
    Race0.01
     Caucasian2066 (74.8)3219 (76.7)
     Indigenous257 (9.3)294 (7.0)
     Asian329 (11.9)512 (12.2)
     Other109 (3.9)173 (4.1)
    Primary renal disease<0.001
     GN646 (23.4)1196 (28.5)
     Analgesic nephropathy82 (3.0)82 (2.0)
     Polycystic kidney disease164 (5.9)267 (6.4)
     Reflux nephropathy75 (2.7)166 (4.0)
     Hypertension428 (15.5)569 (13.6)
     Diabetic nephropathy963 (34.9)1306 (31.1)
     Other235 (8.5)364 (8.7)
     Uncertain168 (6.1)248 (5.9)
    BMI (kg/m2)26.1 (22.8, 30.1)26.2 (22.8, 30.0)0.95
    Smoking at RRT entry0.99
     Never1322 (48.0)2008 (47.9)
     Former1080 (39.2)1641 (39.2)
     Current352 (12.8)539 (12.9)
    Diabetes1234 (44.7)1716 (40.9)0.002
    Coronary artery disease1114 (40.3)1531 (36.5)0.001
    Peripheral vascular disease751 (27.2)942 (22.4)<0.001
    Chronic lung disease455 (16.5)607 (14.5)0.02
    Cerebrovascular disease444 (16.1)561 (13.4)0.002
    PET at baseline (4-h dialysate/plasma creatinine)a0.69 (0.14)0.69 (0.14)0.29
    • Data are presented as n (%) or median (interquartile range). The CAPD group never received APD, whereas the APD group received APD at least once. APD, automated peritoneal dialysis; BMI, body mass index; CAPD, continuous ambulatory peritoneal dialysis; PD, peritoneal dialysis; PET, peritoneal equilibrium test.

    • ↵a Missing in 29% of cohort. All other values missing in <1%.

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    Table 2.

    Results of multivariable Cox proportional hazards model analyses for time to first episode of peritonitis in all patients commencing PD in Australia between 2003 and 2011

    FactorHR95% CIP Value
    APD0.980.91 to 1.070.71
    RRT before PD1.161.07 to 1.25<0.001
    Age at PD start1.001.00 to 1.000.24
    Race
     Caucasian1a
     Indigenous1.671.45 to 1.92<0.001
     Asian0.880.78 to 0.990.04
     Other1.080.91 to 1.290.38
    BMI (kg/m2)1.011.01 to 1.02<0.001
    Diabetes1.091.07 to 1.180.03
    Coronary artery disease1.070.99 to 1.160.11
    Smoking at RRT entry
     Never1a
     Former1.121.04 to 1.210.004
     Current1.121.01 to 1.260.04
    Cerebrovascular disease1.141.03 to 1.270.01
    • 95% CI, 95% confidence interval; HR, hazard ratio.

    • ↵a Reference group.

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Clinical Journal of the American Society of Nephrology: 9 (6)
Clinical Journal of the American Society of Nephrology
Vol. 9, Issue 6
June 06, 2014
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The Association between Peritoneal Dialysis Modality and Peritonitis
Patrick G. Lan, David W. Johnson, Stephen P. McDonald, Neil Boudville, Monique Borlace, Sunil V. Badve, Kamal Sud, Philip A. Clayton
CJASN Jun 2014, 9 (6) 1091-1097; DOI: 10.2215/CJN.09730913

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The Association between Peritoneal Dialysis Modality and Peritonitis
Patrick G. Lan, David W. Johnson, Stephen P. McDonald, Neil Boudville, Monique Borlace, Sunil V. Badve, Kamal Sud, Philip A. Clayton
CJASN Jun 2014, 9 (6) 1091-1097; DOI: 10.2215/CJN.09730913
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Cited By...

  • Peritoneal Dialysis-Associated Peritonitis
  • The Effect of Automated Versus Continuous Ambulatory Peritoneal Dialysis on Mortality Risk In China
  • Outcomes of Acinetobacter Peritonitis in Peritoneal Dialysis Patients: A Multicenter Registry Analysis
  • Outcomes of Corynebacterium Peritonitis: A Multicenter Registry Analysis
  • Kinetic Modeling of Incremental Ambulatory Peritoneal Dialysis Exchanges
  • Risk of Peritoneal Dialysis-Related Peritonitis in a Multi-Racial Asian Population
  • Possible role of IL-6 and TIE2 gene polymorphisms in predicting the initial high transport status in patients with peritoneal dialysis: an observational study
  • ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment
  • Center-Specific Factors Associated with Peritonitis Risk--A Multi-Center Registry Analysis
  • Is Peritonitis Risk Increased in Elderly Patients on Peritoneal Dialysis? Report from the French Language Peritoneal Dialysis Registry (RDPLF)
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