Peritonitis tied to cardiovascular mortality in peritoneal dialysis population

For patients receiving peritoneal dialysis, peritonitis is associated with an increased risk for cardiovascular mortality, according to a study published in the November issue of Kidney International Reports.

Using data from the Australia and New Zealand Dialysis and Transplant registry, Hicham I. Cheikh Hassan, M.B.B.S., from Wollongong Hospital in Australia, and colleagues examined the association between peritonitis and cardiovascular mortality among adults commencing peritoneal dialysis in Australia from October 2003 to December 2019. Data were included for 9,699 incident peritoneal dialysis patients.

The researchers found that the overall rate of peritonitis was 0.37 episodes per patient-year; during the study period, there was a 4.7 percent decrease in the rate. There was an association noted between peritonitis and increased cardiovascular mortality risk (subdistribution hazard ratio, 1.53), with a higher risk seen in association with increasing peritonitis episodes (subdistribution hazard ratio, 1.41 and 1.69 for one and at least two episodes of peritonitis, respectively). Compared with patients who commenced peritoneal dialysis between 2003 and 2011, those who commenced between 2012 and 2019 had a lower risk for cardiovascular mortality (subdistribution hazard ratio, 0.60). In the sensitivity analysis, results were consistent.

“These findings reinforce the importance of targeting further reduction in peritonitis rates through continuous quality improvements,” the authors write. “Future studies should focus on examining closely the trend between peritonitis rate and adverse events, considering other factors which could be influencing such trends.”

One author disclosed financial ties to the pharmaceutical industry.

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