Effect of diabetes on incidence of peritoneal dialysis-associated peritonitis


Autoři: Risa Ueda aff001;  Masatsugu Nakao aff001;  Yukio Maruyama aff001;  Akio Nakashima aff001;  Izumi Yamamoto aff001;  Nanae Matsuo aff001;  Yudo Tanno aff001;  Ichiro Ohkido aff001;  Masato Ikeda aff001;  Hiroyasu Yamamoto aff001;  Keitaro Yokoyama aff001;  Takashi Yokoo aff001
Působiště autorů: Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan aff001
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225316

Souhrn

Background

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.

Methods

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.

Results

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).

Conclusions

The increased risk of peritonitis in diabetics reported in previous periods has not been evident in recent years.

Klíčová slova:

Medical dialysis – Methicillin-resistant Staphylococcus aureus – Peritonitis – Staphylococcus – Staphylococcus epidermidis – Streptococcal infections – Biocompatibility


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Článek vyšel v časopise

PLOS One


2019 Číslo 12