Factors Predicting Peritonitis in Patients with End-stage Renal Disease undergoing Peritoneal Dialysis
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Abstract
The purpose of this retrospective cohort study was to examine the incidence and factors associated with peritonitis among the patients undergoing peritoneal dialysis. The data were collected from medical records of the patient and peritoneal dialysis excel data-based of 250 patients at the hemodialysis unit, Buddhasothorn Hospital during 2014 - 2019. The purposive sampling was used to recruit the participants. The data were collected using patient and laboratory record form. The data were analyzed using descriptive statistics, independent t-test, relative risk, and Binary logistic regression.
The results revealed that 1) The incidence of first peritonitis episodes of end-stage kidney disease patients undergoing continuous ambulatory peritoneal dialysis was 20 percent. 2) The patients undergoing continuous ambulatory peritoneal dialysis who have a history of steroid use more likely to get peritonitis 1.90 times than those who have no history of steroid use (OR = 1.9, 95%CI = 1.0 - 3.6, p = .045). The increasing of 1 gm% of serum albumin level in patient undergoing peritoneal dialysis will decreases the risk of the first episode of peritonitis 0.5 time (OR = .5, 95%CI = .3 - .9, p = .022). The patient who has a smoking history more likely to get peritonitis 1.78 times than those who have no history of smoking (OR = 1.8, 95%CI = 1.2 - 2.7, p = .008). The three predictors explained 14.2% of the variance (Nagelkerke R2 = .142) in predicting the first episode of peritonitis among patients with end-stage renal disease undergoing peritoneal dialysis.
Based on the results of this study steroid use, albumin level, and smoking history could predict peritonitis. The health care providers should establish strategies to prevent peritonitis, especially malnutrition prevention, harmful steroids used, and programs promoting smoking cessation.
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