Annie-Claire Nadeau-Fredette1, David W Johnson2, Carmel M Hawley3, Elaine M Pascoe4, Yeoungjee Cho3, Philip A Clayton5, Monique Borlace6, Sunil V Badve7, Kamal Sud8, Neil Boudville9, Stephen P McDonald10. 1. Department of Renal Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada. 2. Department of Renal Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Australia david.johnson2@health.qld.gov.au. 3. Department of Renal Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Australia. 4. School of Medicine, University of Queensland, Brisbane, Australia. 5. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia Department of Nephrology, Prince of Wales Hospital, Sydney, Australia Faculty of Medicine, University of Sydney, Nepean Clinical School, Kingswood, Australia. 6. Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia. 7. Department of Renal Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia. 8. Faculty of Medicine, University of Sydney, Nepean Clinical School, Kingswood, Australia Departments of Renal Medicine, Nepean and Westmead Hospitals, Sydney, Australia. 9. School of Medicine and Pharmacology, University of Western Australia, Australia. 10. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.
Abstract
UNLABELLED: ♦ BACKGROUND: Previous studies have reported significant variation in peritonitis rates across dialysis centers. Limited evidence is available to explain this variability. The aim of this study was to assess center-level predictors of peritonitis and their relationship with peritonitis rate variations. ♦ METHODS: All incident peritoneal dialysis (PD) patients treated in Australia between October 2003 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant Registry. The primary outcome was peritonitis rate, evaluated in a mixed effects negative binomial regression model. Peritonitis-free survival was assessed as a secondary outcome in a Cox proportional hazards model. ♦ RESULTS: Overall, 8,711 incident PD patients from 51 dialysis centers were included in the study. Center-level predictors of lower peritonitis rates included smaller center size, high proportion of PD, low peritoneal equilibration test use at PD start, and low proportion of hospitalization for peritonitis. In contrast, a low proportion of automated PD exposure, high icodextrin exposure and low or high use of antifungal prophylaxis at the time of peritonitis were associated with a higher peritonitis rate. Similar results were obtained for peritonitis-free survival. Overall, accounting for center-level characteristics appreciably decreased peritonitis variability among dialysis centers (p = 0.02). ♦ CONCLUSION: This study identified specific center-level characteristics associated with the variation in peritonitis risk. Whether these factors are directly related to peritonitis risk or surrogate markers for other center characteristics is uncertain and should be validated in further studies.
UNLABELLED: ♦ BACKGROUND: Previous studies have reported significant variation in peritonitis rates across dialysis centers. Limited evidence is available to explain this variability. The aim of this study was to assess center-level predictors of peritonitis and their relationship with peritonitis rate variations. ♦ METHODS: All incident peritoneal dialysis (PD) patients treated in Australia between October 2003 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant Registry. The primary outcome was peritonitis rate, evaluated in a mixed effects negative binomial regression model. Peritonitis-free survival was assessed as a secondary outcome in a Cox proportional hazards model. ♦ RESULTS: Overall, 8,711 incident PDpatients from 51 dialysis centers were included in the study. Center-level predictors of lower peritonitis rates included smaller center size, high proportion of PD, low peritoneal equilibration test use at PD start, and low proportion of hospitalization for peritonitis. In contrast, a low proportion of automated PD exposure, high icodextrin exposure and low or high use of antifungal prophylaxis at the time of peritonitis were associated with a higher peritonitis rate. Similar results were obtained for peritonitis-free survival. Overall, accounting for center-level characteristics appreciably decreased peritonitis variability among dialysis centers (p = 0.02). ♦ CONCLUSION: This study identified specific center-level characteristics associated with the variation in peritonitis risk. Whether these factors are directly related to peritonitis risk or surrogate markers for other center characteristics is uncertain and should be validated in further studies.
Authors: Neil Boudville; Anna Kemp; Philip Clayton; Wai Lim; Sunil V Badve; Carmel M Hawley; Stephen P McDonald; Kathryn J Wiggins; Kym M Bannister; Fiona G Brown; David W Johnson Journal: J Am Soc Nephrol Date: 2012-05-24 Impact factor: 10.121
Authors: Joanna R Ghali; Kym M Bannister; Fiona G Brown; Johan B Rosman; Kathryn J Wiggins; David W Johnson; Stephen P McDonald Journal: Perit Dial Int Date: 2011-06-30 Impact factor: 1.756
Authors: David W Johnson; Yeoungjee Cho; Brian E R Livingston; Carmel M Hawley; Stephen P McDonald; Fiona G Brown; Johan B Rosman; Kym M Bannister; Kathryn J Wiggins Journal: Kidney Int Date: 2010-03-10 Impact factor: 10.612
Authors: Wai H Lim; Neil Boudville; Stephen P McDonald; Gillian Gorham; David W Johnson; Matthew Jose Journal: Nephrol Dial Transplant Date: 2011-03-07 Impact factor: 5.992
Authors: Gertrude Kopriva-Altfahrt; Paul König; Michael Mündle; Friedrich Prischl; Johannes M Roob; Martin Wiesholzer; Andreas Vychytil; Kalus Arneitz; Andrea Karner; Rene Artes; Erich Wolf; Martin Auinger; Andrzej Pawlak; Johannes Fraberger; Sabine Hofbauer; Georg Galvan; Hermann Salmhofer; Birgit Pichler; Melanie Wazel; Manfred Gruber; Anni Thonhofer; Alfred Hager; Sabine Malajner; Susanne Heiss; Thomas Braunsteiner; Monika Zweiffler; Paul König; Michael Rudnicki; Richard Kogler; Dietmar Kohlhauser; Tatjana Wiesinger; Gertrude Kopriva-Altfahrt; Elizabeth Moser; Peter Kotanko; Herbert Loibner; Helga Nitz; Hans Joachim Miska; René Wenzel; Monika Wölfer; Michael Mündle; Heimo Breuss; Bertram Hölzl; Friedrich Prischi; Bernhard Schmekal; Eva-Maria Riener; Johannes M Roob; Waltraud Wonisch; Rudolf Vikydal; Andreas Vychytil; Barbara Frank; Clemens Wieser; Martin Wiesholzer; Karin Pokorny Journal: Perit Dial Int Date: 2009 May-Jun Impact factor: 1.756
Authors: Yeoungjee Cho; Sunil V Badve; Carmel M Hawley; Stephen P McDonald; Fiona G Brown; Neil Boudville; Kathryn J Wiggins; Kym M Bannister; Philip Clayton; David W Johnson Journal: Perit Dial Int Date: 2012-09-01 Impact factor: 1.756
Authors: Htay Htay; Yeoungjee Cho; Elaine M Pascoe; Darsy Darssan; Annie-Claire Nadeau-Fredette; Carmel Hawley; Philip A Clayton; Monique Borlace; Sunil V Badve; Kamal Sud; Neil Boudville; Stephen P McDonald; David W Johnson Journal: Clin J Am Soc Nephrol Date: 2017-06-21 Impact factor: 8.237
Authors: Laura Sola; Nathan W Levin; David W Johnson; Roberto Pecoits-Filho; Harith M Aljubori; Yuqing Chen; Stefaan Claus; Allan Collins; Brett Cullis; John Feehally; Paul N Harden; Mohamed H Hassan; Fuad Ibhais; Kamyar Kalantar-Zadeh; Adeera Levin; Abdulkarim Saleh; Daneil Schneditz; Irma Tchokhonelidze; Rumeyza Turan Kazancioglu; Ahmed Twahir; Robert Walker; Anthony J O Were; Xueqing Yu; Fredric O Finkelstein Journal: Kidney Int Suppl (2011) Date: 2020-02-19
Authors: Neil Boudville; David W Johnson; Junhui Zhao; Brian A Bieber; Ronald L Pisoni; Beth Piraino; Judith Bernardini; Sharon J Nessim; Yasuhiko Ito; Graham Woodrow; Fiona Brown; John Collins; Talerngsak Kanjanabuch; Cheuk-Chun Szeto; Jeffrey Perl Journal: Nephrol Dial Transplant Date: 2019-12-01 Impact factor: 5.992