Retrospective Analysis of Multi-Center Peritoneal Dialysis- Associated Peritonitis in Jiangsu Province: A Retrospective Analysis from 2016 to 2024

Abstract

Objective: Exploring the incidence of peritoneal dialysis-associated peritonitis (PDAP) and its influencing factors in Jiangsu Province. Methods: An analysis was conducted on a cohort of 392 individuals undergoing peritoneal dialysis (PD) in a retrospective manner from 1 Jan. 2016 to 31 Nov. 2024 in three hospitals in southern (Nantong), northern (Xuzhou) and central (Yancheng) Jiangsu Province, and the incidence of PDAP from 1 Nov. 2023 to 31 Nov. 2024. This study collected basic information, social and environmental factors, medical factors, infection-related factors, dialysis-related factors and complications in PD patients through the online system of three hospitals, and through face-to-face communication during patients' follow-up, collected patients’ anxiety, depression, mental resilience, sleep quality, and cognitive function through scales. Pearson correlation analysis was used for continuous variables and rank variables, a T-test was used to compare means between two groups, while one-way ANOVA was applied for comparisons across multiple groups, least significant difference method (LSD) was used for pound-wise comparison when variance was homogeneous, and Games-Howell method was used when variance was uneven. A multiple stepwise regression method was used to analyze the influence of risk factors on the incidence of PDAP. Results: The occurrence rate of PDAP was 0.31 episodes/patient-year. Mono-factor analysis showed that: dialysate bags/24 hrs (t=-4.375, P<0.001), serum potassium (t=5.001, P<0.001), serum albumin (t=4.934, P<0.001), alanine aminotransferase (ALT) (t=2.175, P=0.032), triglyceride (t=-2.399, P=0.019), total score of MMSE (t=6.502, P<0.001), educational background (χ²=12.065, P=0.007), PD patients with catheter and tunnel exit infection (χ²=61.128, P<0.001) and diabetes mellitus (DM) (χ²=15.527, P<0.001) had statistical significance on the occurrence of PDAP (P<0.05). The results of logistic regression analysis were: serum potassium (odds ratio[OR], 0.403; 95% confidence interval[95%CI], 0.240-0.677), serum albumin (OR, 0.892; 95%CI, 0.833-0.956), triglyceride (OR, 1.780; 95%CI, 1.356-2.377), catheter and tunnel exit infection (OR, 62.267; 95%CI, 7.916-489.787), DM (OR, 3.360; 95%CI, 1.363-8.282) and total score of MMSE (OR, 0.737; 95%CI, 0.637-0.853) were risk factors for PDAP. Conclusions: Serum potassium, serum albumin, triglyceride, total score of MMSE, PD patients with catheter and tunnel exit infection and DM were independent risk factors for the incidence of PDAP, but the effects of triglyceride and the number of 24-hour dialysis bag on PDAP still need to be further investigated.