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Modifiable risk factors for peritoneal dialysis-related infections - a population-based cohort study on risk factors and outcomes in South Sweden

Ljungquist, Oskar LU ; Tobijaszewska, Marta ; Torisson, Gustav LU orcid ; Martus, Giedre LU orcid ; Segelmark, Mårten LU orcid and Tverring, Jonas LU orcid (2025) In Frontiers in Nephrology 5.
Abstract

BACKGROUND: The risk of infection-related death is high in patients undergoing dialysis. This study aimed to identify the modifiable risk factors for PD-related infections in patients undergoing peritoneal dialysis.

METHODS: This was a population-based retrospective cohort study conducted in Skåne, South Sweden, which included all patients receiving peritoneal dialysis (PD) between 2011 and 2020. The primary outcome was PD-related peritonitis, and the secondary outcome was a composite of PD-related infections, that is, peritonitis, exit site, or tunnel infections. Time-to-event frailty models, unadjusted and adjusted for age at PD start, sex and Charleson comorbidity index, were used to investigate potentially modifiable risk... (More)

BACKGROUND: The risk of infection-related death is high in patients undergoing dialysis. This study aimed to identify the modifiable risk factors for PD-related infections in patients undergoing peritoneal dialysis.

METHODS: This was a population-based retrospective cohort study conducted in Skåne, South Sweden, which included all patients receiving peritoneal dialysis (PD) between 2011 and 2020. The primary outcome was PD-related peritonitis, and the secondary outcome was a composite of PD-related infections, that is, peritonitis, exit site, or tunnel infections. Time-to-event frailty models, unadjusted and adjusted for age at PD start, sex and Charleson comorbidity index, were used to investigate potentially modifiable risk factors for PD-related infections. Cox regression models were subsequently used to analyze the relationship between PD-related infection episodes and all-cause mortality during the study period.

RESULTS: In total, 545 patients were included in the study, of whom 212 (39%) patients had at least one episode of peritonitis during a median follow-up time of 1.6 years. We found that BMI ≥ 30 may be associated with a clinically relevant increased risk for PD-related infection (aHR 1.45, 95% CI 1.08-1.93, p-value 0.012, nevents = 486), but not for peritonitis alone (adjusted Hazard Ratio, aHR, 1.34, 95% CI 0.95- 1.91; p = 0.099; nevents = 365). Patients with >3 peritonitis episodes had an almost three-fold increased risk of all-cause mortality (aHR, 2.66; 95% CI 1.56-4.52, p < 0.001).

CONCLUSION: We found that a BMI ≥ 30 may be a modifiable risk factor for peritoneal dialysis-related infections and that multiple episodes of infectious complications of peritoneal dialysis are associated with increased all-cause mortality.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Frontiers in Nephrology
volume
5
article number
1583675
publisher
Frontiers Media S. A.
external identifiers
  • pmid:41001563
ISSN
2813-0626
DOI
10.3389/fneph.2025.1583675
language
English
LU publication?
yes
additional info
Copyright © 2025 Ljungquist, Tobijaszewska, Torisson, Martus, Segelmark and Tverring.
id
98c1d14c-4a61-42aa-8fd3-5bfb03c4f245
date added to LUP
2025-09-26 12:51:56
date last changed
2025-09-26 12:51:56
@article{98c1d14c-4a61-42aa-8fd3-5bfb03c4f245,
  abstract     = {{<p>BACKGROUND: The risk of infection-related death is high in patients undergoing dialysis. This study aimed to identify the modifiable risk factors for PD-related infections in patients undergoing peritoneal dialysis.</p><p>METHODS: This was a population-based retrospective cohort study conducted in Skåne, South Sweden, which included all patients receiving peritoneal dialysis (PD) between 2011 and 2020. The primary outcome was PD-related peritonitis, and the secondary outcome was a composite of PD-related infections, that is, peritonitis, exit site, or tunnel infections. Time-to-event frailty models, unadjusted and adjusted for age at PD start, sex and Charleson comorbidity index, were used to investigate potentially modifiable risk factors for PD-related infections. Cox regression models were subsequently used to analyze the relationship between PD-related infection episodes and all-cause mortality during the study period.</p><p>RESULTS: In total, 545 patients were included in the study, of whom 212 (39%) patients had at least one episode of peritonitis during a median follow-up time of 1.6 years. We found that BMI ≥ 30 may be associated with a clinically relevant increased risk for PD-related infection (aHR 1.45, 95% CI 1.08-1.93, p-value 0.012, nevents = 486), but not for peritonitis alone (adjusted Hazard Ratio, aHR, 1.34, 95% CI 0.95- 1.91; p = 0.099; nevents = 365). Patients with &gt;3 peritonitis episodes had an almost three-fold increased risk of all-cause mortality (aHR, 2.66; 95% CI 1.56-4.52, p &lt; 0.001).</p><p>CONCLUSION: We found that a BMI ≥ 30 may be a modifiable risk factor for peritoneal dialysis-related infections and that multiple episodes of infectious complications of peritoneal dialysis are associated with increased all-cause mortality.</p>}},
  author       = {{Ljungquist, Oskar and Tobijaszewska, Marta and Torisson, Gustav and Martus, Giedre and Segelmark, Mårten and Tverring, Jonas}},
  issn         = {{2813-0626}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Nephrology}},
  title        = {{Modifiable risk factors for peritoneal dialysis-related infections - a population-based cohort study on risk factors and outcomes in South Sweden}},
  url          = {{http://dx.doi.org/10.3389/fneph.2025.1583675}},
  doi          = {{10.3389/fneph.2025.1583675}},
  volume       = {{5}},
  year         = {{2025}},
}