The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study
<p>Abstract</p> <p>Background</p> <p>The aim of the study was to determine whether distance between residence and peritoneal dialysis (PD) unit influenced peritonitis occurrence, microbiology, treatment and outcomes.</p> <p>Methods</p> <p>The stu...
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| Format: | Article |
| Language: | English |
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BMC
2012-06-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-2369/13/41 |
| _version_ | 1818524731469463552 |
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| author | Cho Yeoungjee Badve Sunil V Hawley Carmel M McDonald Stephen P Brown Fiona G M Neil Wiggins Kathryn J Bannister Kym M Clayton Philip Johnson David W |
| author_facet | Cho Yeoungjee Badve Sunil V Hawley Carmel M McDonald Stephen P Brown Fiona G M Neil Wiggins Kathryn J Bannister Kym M Clayton Philip Johnson David W |
| author_sort | Cho Yeoungjee |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The aim of the study was to determine whether distance between residence and peritoneal dialysis (PD) unit influenced peritonitis occurrence, microbiology, treatment and outcomes.</p> <p>Methods</p> <p>The study included all patients receiving PD between 1/10/2003 and 31/12/2008, using ANZDATA Registry data.</p> <p>Results</p> <p>365 (6%) patients lived ≥100 km from their nearest PD unit (distant group), while 6183 (94%) lived <100 km (local group). Median time to first peritonitis in distant patients (1.34 years, 95% CI 1.07-1.61) was significantly shorter than in local patients (1.68 years, 95% CI 1.59-1.77, p = 0.001), whilst overall peritonitis rates were higher in distant patients (incidence rate ratio 1.32, 95% CI 1.20-1.46). Living ≥100 km away from a PD unit was independently associated with a higher risk of <it>S. aureus</it> peritonitis (adjusted odds ratio [OR] 1.64, 95% CI 1.09-2.47). Distant patients with first peritonitis episodes were less likely to be hospitalised (64% vs 73%, p = 0.008) and receive antifungal prophylaxis (4% vs 10%, p = 0.01), but more likely to receive vancomycin-based antibiotic regimens (52% vs 42%, p < 0.001). Using multivariable logistic regression analysis of peritonitis outcomes, distant patients were more likely to be cured with antibiotics alone (OR 1.55, 95% CI 1.03-2.24). All other outcomes were comparable between the two groups.</p> <p>Conclusions</p> <p>Living ≥100 km away from a PD unit was associated with increased risk of <it>S. aureus</it> peritonitis, modified approaches to peritonitis treatment and peritonitis outcomes that were comparable to, or better than patients living closer to a PD unit. Staphylococcal decolonisation should receive particular consideration in remote living patients.</p> |
| first_indexed | 2024-12-11T06:00:45Z |
| format | Article |
| id | doaj.art-3700ed1f810141baa9115e1b0d260d9d |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-11T06:00:45Z |
| publishDate | 2012-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-3700ed1f810141baa9115e1b0d260d9d2022-12-22T01:18:29ZengBMCBMC Nephrology1471-23692012-06-011314110.1186/1471-2369-13-41The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry studyCho YeoungjeeBadve Sunil VHawley Carmel MMcDonald Stephen PBrown Fiona GM NeilWiggins Kathryn JBannister Kym MClayton PhilipJohnson David W<p>Abstract</p> <p>Background</p> <p>The aim of the study was to determine whether distance between residence and peritoneal dialysis (PD) unit influenced peritonitis occurrence, microbiology, treatment and outcomes.</p> <p>Methods</p> <p>The study included all patients receiving PD between 1/10/2003 and 31/12/2008, using ANZDATA Registry data.</p> <p>Results</p> <p>365 (6%) patients lived ≥100 km from their nearest PD unit (distant group), while 6183 (94%) lived <100 km (local group). Median time to first peritonitis in distant patients (1.34 years, 95% CI 1.07-1.61) was significantly shorter than in local patients (1.68 years, 95% CI 1.59-1.77, p = 0.001), whilst overall peritonitis rates were higher in distant patients (incidence rate ratio 1.32, 95% CI 1.20-1.46). Living ≥100 km away from a PD unit was independently associated with a higher risk of <it>S. aureus</it> peritonitis (adjusted odds ratio [OR] 1.64, 95% CI 1.09-2.47). Distant patients with first peritonitis episodes were less likely to be hospitalised (64% vs 73%, p = 0.008) and receive antifungal prophylaxis (4% vs 10%, p = 0.01), but more likely to receive vancomycin-based antibiotic regimens (52% vs 42%, p < 0.001). Using multivariable logistic regression analysis of peritonitis outcomes, distant patients were more likely to be cured with antibiotics alone (OR 1.55, 95% CI 1.03-2.24). All other outcomes were comparable between the two groups.</p> <p>Conclusions</p> <p>Living ≥100 km away from a PD unit was associated with increased risk of <it>S. aureus</it> peritonitis, modified approaches to peritonitis treatment and peritonitis outcomes that were comparable to, or better than patients living closer to a PD unit. Staphylococcal decolonisation should receive particular consideration in remote living patients.</p>http://www.biomedcentral.com/1471-2369/13/41AntibioticsBacteriaFungusMicrobiologyPeritoneal DialysisPeritonitisOutcomesRelapseRemoteness |
| spellingShingle | Cho Yeoungjee Badve Sunil V Hawley Carmel M McDonald Stephen P Brown Fiona G M Neil Wiggins Kathryn J Bannister Kym M Clayton Philip Johnson David W The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study BMC Nephrology Antibiotics Bacteria Fungus Microbiology Peritoneal Dialysis Peritonitis Outcomes Relapse Remoteness |
| title | The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study |
| title_full | The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study |
| title_fullStr | The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study |
| title_full_unstemmed | The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study |
| title_short | The effects of living distantly from peritoneal dialysis units on peritonitis risk, microbiology, treatment and outcomes: a multi-centre registry study |
| title_sort | effects of living distantly from peritoneal dialysis units on peritonitis risk microbiology treatment and outcomes a multi centre registry study |
| topic | Antibiotics Bacteria Fungus Microbiology Peritoneal Dialysis Peritonitis Outcomes Relapse Remoteness |
| url | http://www.biomedcentral.com/1471-2369/13/41 |
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