Dev Jegatheesan1,2, David W Johnson1,2,3,4, Yeoungjee Cho1,2,3, Elaine M Pascoe3, Darsy Darssan3, Htay Htay1,5, Carmel Hawley1,2,3,4, Philip A Clayton1,6,7, Monique Borlace6, Sunil V Badve1,8, Kamal Sud1,9,10, Neil Boudville11, Stephen P McDonald1,7, Annie-Claire Nadeau-Fredette12. 1. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia. 2. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia. 3. Australasian Kidney Trials Network, Diamantina Institute, University of Queensland, Brisbane, Australia. 4. Translational Research Institute, Brisbane, Australia. 5. Department of Nephrology, Singapore General Hospital, Singapore. 6. Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia. 7. School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia. 8. Department of Nephrology, St George Hospital, Sydney, Australia. 9. Departments of Renal Medicine, Nepean and Westmead Hospitals, Sydney, Australia. 10. University of Sydney Medical School, Sydney, Australia. 11. School of Medicine and Pharmacology, University of Western Australia, Australia. 12. Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada ac.nadeau-fredette@umontreal.ca.
Abstract
BACKGROUND: Obesity is increasingly prevalent worldwide, and a greater number of patients initiate renal replacement therapy with a high body mass index (BMI). This study aimed to evaluate the association between BMI and organism-specific peritonitis. METHODS: All adult patients who initiated peritoneal dialysis (PD) in Australia between January 2004 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. The co-primary outcomes of this study were time to first organism-specific peritonitis episode, specifically gram-positive, gram-negative, culture-negative, and fungal. Secondary outcomes were individual rates of organism-specific peritonitis for the same 4 microbiological categories. RESULTS: There were 7,381 peritonitis episodes among the 8,343 incident PD patients evaluated. After multivariable adjustment, obese patients (BMI 30 - 34.9 kg/m2) had an increased risk of fungal peritonitis (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.18 - 2.42), very obese patients (BMI ≥ 35 kg/m2) had a significantly higher risk of gram-positive peritonitis (HR 1.15, 95% CI 1.02 - 1.30), while both obese and very obese patients experienced significantly higher risks of gram-negative peritonitis (HR 1.29, 95% CI 1.11 - 1.50 and HR 1.30, 95% CI 1.08 - 1.57, respectively) compared with patients with normal BMI (20 - 24.9 kg/m2). Obesity and severe obesity were independently associated with increased incidence rate ratios of all forms of organism-specific peritonitis with a non-significant trend for severe obesity and gram-negative peritonitis association. CONCLUSION: Among Australian patients, obesity and severe obesity are associated with significantly increased rates of gram-positive, gram-negative, fungal, and culture-negative peritonitis.
BACKGROUND:Obesity is increasingly prevalent worldwide, and a greater number of patients initiate renal replacement therapy with a high body mass index (BMI). This study aimed to evaluate the association between BMI and organism-specific peritonitis. METHODS: All adult patients who initiated peritoneal dialysis (PD) in Australia between January 2004 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. The co-primary outcomes of this study were time to first organism-specific peritonitis episode, specifically gram-positive, gram-negative, culture-negative, and fungal. Secondary outcomes were individual rates of organism-specific peritonitis for the same 4 microbiological categories. RESULTS: There were 7,381 peritonitis episodes among the 8,343 incident PDpatients evaluated. After multivariable adjustment, obesepatients (BMI 30 - 34.9 kg/m2) had an increased risk of fungal peritonitis (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.18 - 2.42), very obesepatients (BMI ≥ 35 kg/m2) had a significantly higher risk of gram-positive peritonitis (HR 1.15, 95% CI 1.02 - 1.30), while both obese and very obesepatients experienced significantly higher risks of gram-negative peritonitis (HR 1.29, 95% CI 1.11 - 1.50 and HR 1.30, 95% CI 1.08 - 1.57, respectively) compared with patients with normal BMI (20 - 24.9 kg/m2). Obesity and severe obesity were independently associated with increased incidence rate ratios of all forms of organism-specific peritonitis with a non-significant trend for severe obesity and gram-negative peritonitis association. CONCLUSION: Among Australian patients, obesity and severe obesity are associated with significantly increased rates of gram-positive, gram-negative, fungal, and culture-negative peritonitis.
Authors: Htay Htay; David W Johnson; Jonathan C Craig; Francesco Paolo Schena; Giovanni Fm Strippoli; Allison Tong; Yeoungjee Cho Journal: Cochrane Database Syst Rev Date: 2019-05-31
Authors: Mark Lambie; Junhui Zhao; Keith McCullough; Simon J Davies; Hideki Kawanishi; David W Johnson; James A Sloand; Mauricio Sanabria; Talerngsak Kanjanabuch; Yong-Lim Kim; Jenny I Shen; Ronald L Pisoni; Bruce M Robinson; Jeffrey Perl Journal: Clin J Am Soc Nephrol Date: 2022-06 Impact factor: 10.614
Authors: Anna A Bonenkamp; Sanne Vonk; Alferso C Abrahams; Yolande M Vermeeren; Anita van Eck van der Sluijs; Tiny Hoekstra; Frans J van Ittersum; Brigit C van Jaarsveld Journal: Nephrology (Carlton) Date: 2022-03-04 Impact factor: 2.358