Among patients who die while on peritoneal dialysis, peritonitis is associated with mortality, with the highest odds for peritonitis in the 30 days before death, according to a study published online ahead of print in the Journal of the American Society of Nephrology.
Neil Boudville, MD, of the Australia and New Zealand Dialysis and Transplant Registry in Adelaide, and colleagues conducted a case-crossover study involving 1,316 patients (mean age, 70 years) who received peritoneal dialysis (mean duration, three years) and either died on peritoneal dialysis or within 30 days of transfer to hemodialysis. Each patient served as his or her own control.
The researchers identified 1,446 reported episodes of peritonitis, with 27% of patients having two or more episodes. There were significantly increased odds of peritonitis during the 120 days before death compared with during the rest of the year, and the magnitude of this association was even greater during the 30 days before death. The odds for peritonitis was sixfold higher during the 30 days immediately before death compared with a 30-day window six months before death.
“Peritonitis significantly associates with mortality in peritoneal dialysis patients,” the authors concluded. “The increased odds extend up to 120 days after an episode of peritonitis but the magnitude is greater during the initial 30 days.”