J Nephropathol. 2019;8(4):36-36.
doi: 10.15171/jnp.2019.36
  Abstract View: 60
  PDF Download: 46

Original Article

Predictors of peritoneal dialysis associated peritonitis; application of the zero-inflated negative binomial model

Shahrokh Ezzatzadegan Jahromi 1 ORCiD, Faisal Ahmed 2 ORCiD, Saeedeh Pourahmad 3,4,5 ORCiD, Jamshid Roozbeh 1 ORCiD, Iraj Najafi 6 ORCiD, Vahid Ebrahimi 1,4,5 * ORCiD

1 Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
3 Bioinformatics and Computational Biology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
4 Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
5 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
6 Department of Nephrology, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: Peritonitis is the main cause of morbidity and dropout from peritoneal dialysis (PD) program.

Objectives: We aimed to determine risk factors predisposing to PD-associated peritonitis.

Patients and Methods: As a retrospective cohort research, on 235 PD individuals with 4277 patientmonths of follow up, 170 episodes of peritonitis was reported in 93 patients. Data were extracted from medical records using a template. Standard as well as zero-inflated negative binominal regression was used to model the association between patients’ characteristics and the peritonitis rate. Cox-proportional hazard (PH) adjusted model was used to determine the effect of factors on the peritonitis-free survival.

Results: With a mean (SD) body mass index (BMI) of 18.7(3.4) kg/m2, 109 (46.4%) of them were male. With a median (95% CI) follow-up time of 19 (16 to 36) months, the rate of peritonitis was 0.48 episode per patient-year. The most common micro-organism detected was coagulase-negative staphylococci (n=54; 31.7%). The only variable which was associated with a higher rate of peritonitis was BMI (rate ratio [RR]: 1.07; 95% CI 1.01 to 1.14; P value=0.031). Comparing to patients with lower education, patients with higher than elementary school of education had higher peritonitisfree survival (with hazard ratio [HR]=0.51; 95%CI 0.33-0.79, P value=0.003) and higher chance of having no peritonitis [odds ratio (OR):1.97; 95% CI 1.08 to 3.59; P value=0.029].

Conclusion: Peritonitis is still a major concern in PD patients. BMI was a risk factor for higher peritonitis rate. Higher education level was associated with lower peritonitis-free survival and higher chance of having no peritonitis.

Implication for health policy/practice/research/medical education: In a retrospective study on 235 peritoneal dialysis patients with 4277 patient-months of follow up, with 170 episodes of peritonitis in 93 patients, we found body mass index was a risk factor for higher peritonitis rate.

Please cite this paper as: Ezzatzadegan Jahromi S, Ahmed F, Pourahmad S, Roozbeh J, Najafi I, Ebrahimi V. Predictors of peritoneal dialysis associated peritonitis; application of the zero-inflated negative binomial model. J Nephropathol. 2019;8(4):e36. DOI: 10.15171/jnp.2019.36.

First name
 
Last name
 
Email address
 
Comments
 
Security code


Article Viewed: 60

Your browser does not support the canvas element.


PDF Downloaded: 46

Your browser does not support the canvas element.

Submitted: 29 Mar 2019
Accepted: 13 May 2019
First published online: 23 Jul 2019
EndNote EndNote

(Enw Format - Win & Mac)

BibTeX BibTeX

(Bib Format - Win & Mac)

Bookends Bookends

(Ris Format - Mac only)

EasyBib EasyBib

(Ris Format - Win & Mac)

Medlars Medlars

(Txt Format - Win & Mac)

Mendeley Web Mendeley Web
Mendeley Mendeley

(Ris Format - Win & Mac)

Papers Papers

(Ris Format - Win & Mac)

ProCite ProCite

(Ris Format - Win & Mac)

Reference Manager Reference Manager

(Ris Format - Win only)

Refworks Refworks

(Refworks Format - Win & Mac)

Zotero Zotero

(Ris Format - FireFox Plugin)