Effects of Age and Diabetes Mellitus on Clinical Outcomes in Patients with Peritoneal Dialysis-Related Peritonitis

Background: Peritoneal dialysis (PD)-related peritonitis is the most common complication and the leading cause of technique failure for patients on PD therapy. The aim of this study was to review the episodes and outcomes of PD-related peritonitis, with special reference to the effects of age and diabetes status. Methods: The study comprised 204 consecutive peritonitis episodes between January 2001 and June 2011 from our registry database. Factors associated with treatment failure and mortality were analyzed with multi-variable logistic regression modeling. Results: The overall peritonitis rate was one episode per 65 patient-months or 0.187 episodes/patient-year. Older patients had lower probability of remaining free of peritonitis (log rank, p<0.001). Elderly patients and diabetic subjects had a higher risk of peritonitis-related dropout. Age (odds ratio [OR], 1.37; p=0.041), diabetes mellitus (OR, 3.64; p=0.005), and gram-negative peritonitis (OR, 3.55; p=0.011) were independent determinants of catheter removal. Age (OR, 1.93; p=0.026) and diabetes (OR, 5.98; p=0.015) were the only predictors of death from peritonitis. Conclusions: Old age and diabetes mellitus are two major risk factors for adverse outcomes of PD-related peritonitis. Although they are not contraindications to PD, our results suggest that these patients need meticulous care when peritonitis occurs.