Document Detail


Effects of climatic region on peritonitis risk, microbiology, treatment, and outcomes: a multicenter registry study.
MedLine Citation:
PMID:  22942270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The impact of climatic variations on peritoneal dialysis (PD)-related peritonitis has not been studied in detail. The aim of the current study was to determine whether various climatic zones influenced the probability of occurrence or the clinical outcomes of peritonitis.
METHODS: Using ANZDATA registry data, the study included all Australian patients receiving PD between 1 October 2003 and 31 December 2008. Climatic regions were defined according to the Köppen classification.
RESULTS: The overall peritonitis rate was 0.59 episodes per patient-year. Most of the patients lived in Temperate regions (65%), with others residing in Subtropical (26%), Tropical (6%), and Other climatic regions (Desert, 0.6%; Grassland, 2.3%). Compared with patients in Temperate regions, those in Tropical regions demonstrated significantly higher overall peritonitis rates and a shorter time to a first peritonitis episode [adjusted hazard ratio: 1.15; 95% confidence interval (CI): 1.01 to 1.31]. Culture-negative peritonitis was significantly less likely in Tropical regions [adjusted odds ratio (OR): 0.42; 95% CI: 0.25 to 0.73]; its occurrence in Subtropical and Other regions was comparable to that in Temperate regions. Fungal peritonitis was independently associated with Tropical regions (OR: 2.18; 95% CI: 1.22 to 3.90) and Other regions (OR: 3.46; 95% CI: 1.73 to 6.91), where rates of antifungal prophylaxis were also lower. Outcomes after first peritonitis episodes were comparable in all groups.
CONCLUSIONS: Tropical regions were associated with a higher overall peritonitis rate (including fungal peritonitis) and a shorter time to a first peritonitis episode. Augmented peritonitis prophylactic measures such as antifungal therapy and exit-site care should be considered in PD patients residing in Tropical climates.
Authors:
Yeoungjee Cho; Sunil V Badve; Carmel M Hawley; Stephen P McDonald; Fiona G Brown; Neil Boudville; Kathryn J Wiggins; Kym M Bannister; Philip Clayton; David W Johnson
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2012-09-01
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  33     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:    2013 Jan-Feb
Date Detail:
Created Date:  2013-01-25     Completed Date:  2013-07-16     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  75-85     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / therapeutic use*
Climate Change*
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Peritoneal Dialysis / adverse effects*
Peritonitis / epidemiology,  etiology*,  therapy
Prognosis
Queensland / epidemiology
Registries*
Retrospective Studies
Risk Assessment / methods*
Risk Factors
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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