1. Lower education level is a major risk factor for peritonitis incidence in chronic peritoneal dialysis patients: a retrospective cohort study with 12-year follow-up
- Author
-
Jin-Bor Chen, Yahn-Bor Chern, Li-Chueh Kuo, and Pei-Shan Ho
- Subjects
Chronic peritoneal dialysis ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Taiwan ,Peritonitis ,Peritoneal dialysis ,Young Adult ,Patient Education as Topic ,Risk Factors ,Internal medicine ,medicine ,Confidence Intervals ,Humans ,Risk factor ,Dialysis ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Incidence (epidemiology) ,Incidence ,Retrospective cohort study ,General Medicine ,Original Articles ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Nephrology ,Educational Status ,Kidney Failure, Chronic ,Female ,Complication ,business ,Peritoneal Dialysis ,Follow-Up Studies ,Forecasting - Abstract
Background Peritoneal dialysis (PD)-related peritonitis remains an important complication in PD patients, potentially causing technique failure and influencing patient outcome. To date, no comprehensive study in the Taiwanese PD population has used a time-dependent statistical method to analyze the factors associated with PD-related peritonitis. Methods Our single-center retrospective cohort study, conducted in southern Taiwan between February 1999 and July 2010, used time-dependent statistical methods to analyze the factors associated with PD-related peritonitis. Results The study recruited 404 PD patients for analysis, 150 of whom experienced at least 1 episode of peritonitis during the follow-up period. The incidence rate of peritonitis was highest during the first 6 months after PD start. A comparison of patients in the two groups (peritonitis vs null-peritonitis) by univariate analysis showed that the peritonitis group included fewer men (p = 0.048) and more patients of older age (≥65 years, p = 0.049). In addition, patients who had never received compulsory education showed a statistically higher incidence of PD-related peritonitis in the univariate analysis (p = 0.04). A proportional hazards model identified education level (less than elementary school vs any higher education level) as having an independent association with PD-related peritonitis [hazard ratio (HR): 1.45; 95% confidence interval (CI): 1.01 to 2.06; p = 0.045). Comorbidities measured using the Charlson comorbidity index (score >2 vs ≤2) showed borderline statistical significance (HR: 1.44; 95% CI: 1.00 to 2.13; p = 0.053). Conclusions A lower education level is a major risk factor for PD-related peritonitis independent of age, sex, hypoalbuminemia, and comorbidities. Our study emphasizes that a comprehensive PD education program is crucial for PD patients with a lower education level.
- Published
- 2013