Infection-Related Hospitalizations More Likely with Peritoneal Dialysis

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Peritoneal dialysis (PD) is associated with a significantly greater risk for infection-related hospitalizations than hemodialysis (HD), and this appears to be explained mostly by dialysis-related infections, according to a Canadian study.

PD, however, is associated with a significantly decreased risk of hospitalization for septicemia and pneumonia compared with HD.

In a retrospective investigation, a team led by Jean-Philippe LaFrance, MD, of the University of Montreal, compared 910 PD patients and a like number of HD patients matched by propensity scores. During a median follow-up of 2.1 years, 341 patients were hospitalized once for an infection, 123 were hospitalized twice, and 106 were hospitalized three times. PD was associated with a significant 52% increased risk for infection-related hospitalization compared with HD, the researchers reported in the Clinical Journal of the American Society of Nephrology (2012;7:1598-1605). PD was associated with a 69% decreased risk of septicemia and 42% decreased risk of pneumonia. PD was associated with a significant threefold increased risk of dialysis-related infectious hospitalizations, defined as all cases of peritonitis and vascular access-related bacteremia.

“Because dialysis modality is often a patient's choice when no contraindication exists for one specific modality,” the authors wrote, “a patient should be well informed of the advantages and disadvantages of each modality.”

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