Risk factors of peritoneal dialysis-associated peritonitis and HIV infection_Chinese Journal of Evidence-Based Medicine

Authors：

LI Li ¹ , LI Jian ² , PU Yajun ¹ , YANG Letian ¹ , ZHONG Hui ¹ ,  ZHAO Yuliang ¹ , FU Ping ¹

1. Division of Nephrology, Kidney Research Laboratory, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

ZHAO Yuliang, Email: dr.zhaoyuliang@gmail.com

Keywords：

Peritoneal dialysis; Peritonitis; HIV; Risk factor

DOI：

10.7507/1672-2531.202207119

Video：

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Objective To compare the incidences of peritoneal dialysis (PD)-associated peritonitis among HIV and non-HIV patients, and to analyze the risk factors of PD-associated peritonitis. Methods End-stage renal disease patients with HIV infection who newly started PD in West China Hospital of Sichuan University from 2012 to 2020 were retrospectively included, and non-HIV PD patients in the same period were included as controls at a ratio of 1 to 4. The risk factors of PD-associated peritonitis were analyzed by univariate analysis and multivariate logistic analysis. Kaplan-Meier survival analysis and COX regression analysis were used to compare the peritonitis-free survival between HIV group and non-HIV group. Results A total of 60 PD patients were included. The average follow-up time was 31.2±21.3 months. Peritonitis occurred in 7 HIV patients (58.33%) and 8 non-HIV patients (16.67%). Logistic regression analysis showed that HIV infection (P=0.018) and high platelet (>150×10⁹/L) (P=0.032) were independent risk factors for PD-associated peritonitis. The incidence of PD-associated peritonitis in HIV patients significantly increased (HR=10.944, 95%CI 1.503 to 79.707). Kaplan-Meier survival analysis showed that the 5-year peritonitis-free survival of non-HIV group was significantly higher than that of HIV group (75.7% vs. 31.1%) (P=0.003). Multivariate COX survival analysis showed that the 5-year accumulative risk of peritonitis in HIV PD patients was 5.896 times (95%CI 1.508 to 23.043, P=0.01) higher than that of the non-HIV PD patients. Conclusion HIV infection is an independent risk factor for PD-associated peritonitis.

Citation： LI Li, LI Jian, PU Yajun, YANG Letian, ZHONG Hui, ZHAO Yuliang, FU Ping. Risk factors of peritoneal dialysis-associated peritonitis and HIV infection. Chinese Journal of Evidence-Based Medicine, 2022, 22(12): 1382-1385. doi: 10.7507/1672-2531.202207119 Copy

1.	Abraham AG, Althoff KN, Jing Y, et al. End-stage renal disease among HIV-infected adults in North America. Clin Infect Dis, 2015, 60(6): 941-949.
2.	Tang SCW, Lai KN. Peritoneal dialysis: the ideal bridge from conservative therapy to kidney transplant. J Nephrol, 2020, 33(6): 1189-1194.
3.	Brown MC, Simpson K, Kerssens JJ, et al. Peritoneal dialysis-associated peritonitis rates and outcomes in a national cohort are not improving in the post-millennium (2000-2007). Perit Dial Int, 2011, 31(6): 639-650.
4.	国家疾病预防控制局. 2021年全国法定传染病疫情概况. Available at: http://www.nhc.gov.cn/jkj/s3578/202204/4fd88a291d914abf8f7a91f6333567e1.shtml.
5.	Heron JE, Bagnis CI, Gracey DM. Contemporary issues and new challenges in chronic kidney disease amongst people living with HIV. AIDS Res Ther, 2020, 17(1): 11.
6.	Ryom L, Kirk O, Lundgren JD, et al. Advanced chronic kidney disease, end-stage renal disease and renal death among HIV-positive individuals in Europe. HIV Med, 2013, 14(8): 503-508.
7.	Ndlovu KC, Sibanda W, Assounga A. Peritonitis outcomes in patients with HIV and end-stage renal failure on peritoneal dialysis: a prospective cohort study. BMC Nephrol, 2017, 18(1): 48.
8.	王珍燕, 沈银忠, 张仁芳, 等. 110例人类免疫缺陷病毒感染及获得性免疫缺陷综合征患者合并血小板减少症临床分析. 内科理论与实践, 2013, 8(2): 106-110.
9.	Yang Y, Yuan J, Liu L, et al. Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients. Ren Fail, 2021, 43(1): 1359-1367.
10.	Xu LC, Zhou FF, Li M, et al. Predictive value of peripheral blood neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on patient survival with peritoneal dialysis. Clin Lab, 2021, 67(9): 210124.
11.	Zhu Y, Peng F, Chen Y, et al. Mean platelet volume/platelet count ratio and mortality in patients on peritoneal dialysis. Clin Nephrol, 2018, 90(3): 205-211.

1. Abraham AG, Althoff KN, Jing Y, et al. End-stage renal disease among HIV-infected adults in North America. Clin Infect Dis, 2015, 60(6): 941-949.
2. Tang SCW, Lai KN. Peritoneal dialysis: the ideal bridge from conservative therapy to kidney transplant. J Nephrol, 2020, 33(6): 1189-1194.
3. Brown MC, Simpson K, Kerssens JJ, et al. Peritoneal dialysis-associated peritonitis rates and outcomes in a national cohort are not improving in the post-millennium (2000-2007). Perit Dial Int, 2011, 31(6): 639-650.
4. 国家疾病预防控制局. 2021年全国法定传染病疫情概况. Available at: http://www.nhc.gov.cn/jkj/s3578/202204/4fd88a291d914abf8f7a91f6333567e1.shtml.
5. Heron JE, Bagnis CI, Gracey DM. Contemporary issues and new challenges in chronic kidney disease amongst people living with HIV. AIDS Res Ther, 2020, 17(1): 11.
6. Ryom L, Kirk O, Lundgren JD, et al. Advanced chronic kidney disease, end-stage renal disease and renal death among HIV-positive individuals in Europe. HIV Med, 2013, 14(8): 503-508.
7. Ndlovu KC, Sibanda W, Assounga A. Peritonitis outcomes in patients with HIV and end-stage renal failure on peritoneal dialysis: a prospective cohort study. BMC Nephrol, 2017, 18(1): 48.
8. 王珍燕, 沈银忠, 张仁芳, 等. 110例人类免疫缺陷病毒感染及获得性免疫缺陷综合征患者合并血小板减少症临床分析. 内科理论与实践, 2013, 8(2): 106-110.
9. Yang Y, Yuan J, Liu L, et al. Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients. Ren Fail, 2021, 43(1): 1359-1367.
10. Xu LC, Zhou FF, Li M, et al. Predictive value of peripheral blood neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on patient survival with peritoneal dialysis. Clin Lab, 2021, 67(9): 210124.
11. Zhu Y, Peng F, Chen Y, et al. Mean platelet volume/platelet count ratio and mortality in patients on peritoneal dialysis. Clin Nephrol, 2018, 90(3): 205-211.

Chinese Journal of Evidence-Based Medicine

Risk factors of peritoneal dialysis-associated peritonitis and HIV infection

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