医学
腹膜透析
腹膜炎
相伴的
危险系数
内科学
外科
入射(几何)
回顾性队列研究
风险因素
胃肠病学
置信区间
光学
物理
作者
Michael Rudnicki,Julia Kerschbaum,Johann Hausdorfer,Gert Mayer,Paul König
标识
DOI:10.3747/pdi.2009.00108
摘要
Peritonitis is a major complication of peritoneal dialysis (PD), being associated with hospitalization, catheter loss, technique failure, and increased mortality. Data on various risk factors for peritonitis are inconsistent, and no association with concomitant therapy has been shown. ♢We performed a retrospective analysis of all incident and prevalent PD patients (n = 55) treated in Innsbruck, Austria, between 2000 and 2007. Data consisted of 1291 patient-months and 55 episodes of peritonitis. Patient demographic data, comorbidities, concomitant medication, laboratory parameters, and microbiology results were obtained from the medical records and from the hospital's electronic database. ♢The mean peritonitis incidence rate was 0.51 episodes/patient-year (range: 0.24 - 0.73 episodes/patient-year) or 1 episode every 23.5 months (range: 16 - 50 months). In a primary analysis including demographic characteristics, comorbidities, laboratory parameters, and concomitant medication, only treatment with oral active vitamin D was associated with a significantly lower risk of peritonitis. Adjusted for time on PD and baseline serum albumin, oral active vitamin D therapy was associated with an 80% reduced relative risk of peritonitis [hazard ratio (HR): 0.20; 95% confidence interval (CI): 0.06 to 0.64; p = 0.007)]. The risk reduction was comparable in patients who received 0.25 μg or more of vitamin D daily (HR: 0.18; 95% CI: 0.05 to 0.65; p = 0.008) and in those who received less than 0.25 μg vitamin D daily (HR: 0.21; 95% CI: 0.06 to 0.77; p = 0.018). ♢Treatment with oral active vitamin D might be associated with a lower risk of peritonitis in PD patients.
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