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KMID : 1102220200390040460
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Kidney Research and Clinical Practice
2020 Volume.39 No. 4 p.460 ~ p.468
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Clinical outcomes of infection-related hospitalization in incident peritoneal dialysis patients
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Jeon Young-Dong
Kim Hyung-Duk
Hong Yu-Ah
Kim Hyung-Wook
Yang Chul-Woo
Chang Yoon-Kyung
Kim Yong-Kyun
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Abstract
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Background: Infection is the second leading cause of death in patients undergoing long-term dialysis. Peritoneal dialysis (PD) is associated with an increased risk of infection-related hospitalization (IRH) when compared with hemodialysis. In this study, we investigated the influence of IRH on clinical outcomes in incident PD patients.
Methods: In total, 583 incident PD patients were selected from the Clinical Research Center Registry for End-Stage Renal Disease, a nationwide multicenter prospective observational cohort study in Korea. Incident PD patients who had been hospitalized for infection-related diseases were defined as the IRH group. The primary outcome was all-cause mortality and the secondary outcome was technical failure. The median follow-up period was 29 months.
Results: Seventy-three PD patients (12.5%) were categorized in the IRH group. Multivariable logistic regression analysis showed that diabetes mellitus was a significant independent predictor for IRH (odds ratio, 2.43; 95% confidence interval [CI], 1.12 to 5.29; P = 0.007). The most common causes of IRH were peritonitis (63.0%) and respiratory tract infection (9.6%). Multivariable Cox proportional hazard model analysis showed that IRH was a significant independent risk factor for all-cause mortality (hazard ratio [HR], 2.51; 95% CI, 1.12 to 5.62; P = 0.026) and for the technical failure of PD (HR, 3.23; 95% CI, 1.90 to 5.51; P < 0.001).
Conclusion: Our data showed that after initiation of PD, IRH was significantly associated with higher risk of all-cause mortality and technical failure.
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KEYWORD
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Hospitalization, Infections, Mortality, Peritoneal dialysis, Peritonitis
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