Association of biocompatible peritoneal dialysis solutions with peritonitis risk, treatment, and outcomes

Cho, Yeoungjee, Badve, Sunil V., Hawley, Carmel M., McDonald, Stephen P., Brown, Fiona G., Boudville, Neil, Bannister, Kym M., Clayton, Philip A. and Johnson, David W. (2013) Association of biocompatible peritoneal dialysis solutions with peritonitis risk, treatment, and outcomes. Clinical Journal of the American Society of Nephrology, 8 9: 1556-1563. doi:10.2215/CJN.12361212

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Author Cho, Yeoungjee
Badve, Sunil V.
Hawley, Carmel M.
McDonald, Stephen P.
Brown, Fiona G.
Boudville, Neil
Bannister, Kym M.
Clayton, Philip A.
Johnson, David W.
Title Association of biocompatible peritoneal dialysis solutions with peritonitis risk, treatment, and outcomes
Journal name Clinical Journal of the American Society of Nephrology   Check publisher's open access policy
ISSN 1555-9041
1555-905X
Publication date 2013-09
Year available 2013
Sub-type Article (original research)
DOI 10.2215/CJN.12361212
Open Access Status
Volume 8
Issue 9
Start page 1556
End page 1563
Total pages 8
Place of publication Washington, United States
Publisher American Society of Nephrology
Collection year 2014
Language eng
Formatted abstract
Background and objectives The effect of biocompatible peritoneal dialysis (PD) solutions on PD-related peritonitis is unclear. This study sought to evaluate the relationship between use of biocompatible solutions and the probability of occurrence or clinical outcomes of peritonitis.

Design, setting, participants, & measurements The study included all incident Australian patients receiving PD between January 1, 2007, and December 31, 2010, using Australia and New Zealand Dialysis and Transplant Registry data. All multicompartment PD solutions of neutral pH were categorized as biocompatible solutions. The independent predictors of peritonitis and the use of biocompatible solutions were determined by multivariable, multilevel mixed-effects Poisson and logistic regression analysis, respectively. Sensitivity analyses, including propensity score matching, were performed.

Results Use of biocompatible solutions gradually declined (from 7.5% in 2007 to 4.2% in 2010), with preferential use among smaller units and among younger patients without diabetes mellitus. Treatment with biocompatible solution was associated with significantly greater overall rate of peritonitis (0.67 versus 0.47 episode per patient-year; incidence rate ratio, 1.49; 95% confidence interval [CI], 1.19 to 1.89) and with shorter time to first peritonitis (hazard ratio [HR], 1.48; 95% CI, 1.17 to 1.87), a finding replicated in propensity score–matched cohorts (HR, 1.36; 95% CI, 1.09 to 1.71).

Conclusions In an observational registry study, use of biocompatible PD solutions was associated with higher overall peritonitis rates and shorter time to first peritonitis. Further randomized studies adequately powered for a primary peritonitis outcome are warranted.
Keyword Glucose degradation products
Residual renal function
To mesenchymal transition
Mesothelial cells
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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