(HealthDay News) — Peritoneal dialysis (PD)-associated peritonitis rates have decreased over time, according to a study published online in the American Journal of Kidney Diseases.
Eric W. Young, MD, from Arbor Research Collaborative for Health in Ann Arbor, Michigan, and colleagues conducted a retrospective cohort study of PD-associated peritonitis to characterize trends and identify clinical risk factors. Patients receiving PD treated between 2013 and 2017 who were covered by Medicare fee-for-service were included. The major outcome was peritonitis, identified using diagnosis codes from the International Classification of Diseases, Ninth Edition (ICD-9) and ICD-10.
The researchers identified 70,271 episodes of peritonitis from 396,289 peritonitis claims. Various codes were used to record peritonitis, but none was used predominantly. Episodes of peritonitis were frequently identified by multiple aggregated claims; per episode, there was a mean of 5.6 claims and median of 2 claims. Overall, 40 and 9% of episodes were exclusively outpatient and exclusively inpatient, respectively, and 16% were exclusively based on codes that do not clearly distinguish peritonitis from catheter infections/inflammations. The overall rate of peritonitis was 0.54 episodes per patient-year. There was a 5% reduction in the peritonitis rate per year; the rate varied by patient factors such as age, race, and prior peritonitis episodes.
“Despite the falling rate, our estimate occupies the high end of rates reported in prior studies,” the authors write. “We did not explore the reasons for declining peritonitis rates in our study, but several factors could be involved, including practice guidelines adherence, provider experience, and improvements in PD equipment.”