Risk factors for peritoneal dialysis-related peritonitis: Can we reduce the incidence and improve patient selection?

Background: Peritonitis is a serious complication of peritoneal dialysis (PD) and a major cause of hospitalization, catheter loss, transfer to haemodialysis and death. Thus, it is important to identify risk factors for PD-related peritonitis in order to reduce the incidence and improve patient selection. Methods: This study is a prospective cohort review (1992-2003) with data consisting of 12 844 patient months, 506 PD patients and 623 episodes of peritonitis. Comorbidities and patient demographics were provided by the Australian and New Zealand Dialysis and Transplant Registry and these were merged with the hospital combined clinical and microbiology laboratory peritonitis database. Results: Variables identified to be associated with an increased likelihood of peritonitis were: age (every 10 years; OR, 1.26; 95% CI, 1.07-1.48), gender (female; OR, 1.91; 95% CI, 1.2-3.01), current smoker at entry to dialysis (OR, 1.71; 95% CI, 1.04-2.82) and the pre twin bag connection system (OR, 2.07; 95% CI, 1.22-3.52). Conclusion: Increasing age, female gender and smoking increased the risk of peritonitis. Identifying these risk factors will assist in the selection, training and monitoring of our PD population.