Journal Article

Effect of diabetes on incidence of peritoneal dialysis-associated peritonitis

Tanno, Yudo, Yokoo, Takashi, Yamamoto, Izumi, Yamamoto, Hiroyasu, Maruyama, Yukio, Ikeda, Masato, Ueda, Risa, Matsuo, Nanae, Ohkido, Ichiro, Nakao, Masatsugu, Nakashima, Akio, Yokoyama, Keitaro

2019

Overview

Several reports on patients with diabetes mellitus (DM) treated by peritoneal dialysis (PD) have shown a higher risk of PD-associated peritonitis compared to non-DM (NDM) patients. The aim of this study was to investigate the incidence of PD-associated peritonitis in DM patients. We divided all patients who received PD at a single center between January 1980 and December 2012 into three groups according to era: Period 1 (n = 43, 1980-1993); Period 2 (n = 123, 1994-2004); and Period 3 (n = 207, 2005-2012). We investigated incidences of PD-associated peritonitis between patients with and without DM. In Periods 1 and 2, incidence of PD-associated peritonitis was higher in the DM group than in the NDM group (P<0.05). However, no difference according to presence of DM was seen in Period 3. Multivariate Cox regression analysis revealed DM as a risk factor for incidence of PD-associated peritonitis in Periods 1 and 2, but not in Period 3 (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.15 to 5.23; HR, 2.36; 95%CI, 1.13 to 4.58; and HR, 0.82; 95%CI, 0.41 to 1.54, respectively). Furthermore, the peritonitis-free period was significantly shorter in the DM group than in the DM group in Periods 1 and 2, whereas no significant difference was seen in Period 3 (P<0.01, P<0.01 and P = 0.55, respectively). Moreover, a significant interaction was seen between diabetes and study period, and became less pronounced during Period 3(P<0.01). The increased risk of peritonitis in diabetics reported in previous periods has not been evident in recent years.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Analysis / Biology and Life Sciences / Care and treatment / Confidence intervals / Diabetes / Diabetes Mellitus / Diabetics / Dialysis / Female / Humans / Hypertension / Incidence / Internal medicine / Kidney Failure, Chronic - therapy / Male / Medical equipment industry / Medical records / Medical research / Medicine / Medicine and Health Sciences / Middle Aged / Nephrology / Patients / Peritoneal dialysis / Peritoneal Dialysis - adverse effects / Peritoneum / Peritonitis / Peritonitis - epidemiology / Peritonitis - etiology / Regression analysis / Retrospective Studies / Risk / Risk analysis / Risk factors / Statistical analysis