Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Dec;33(6):1275-1287.
doi: 10.1007/s40620-020-00716-1. Epub 2020 Mar 4.

Changes in serum albumin concentrations during transition to dialysis and subsequent risk of peritonitis after peritoneal dialysis initiation: a retrospective cohort study

Kajohnsak Noppakun  1   2 , Thanit Kasemset  1 , Uraiwan Wongsawad  1 , Chidchanok Ruengorn  2   3 , Kednapa Thavorn  2   4   5   6 , Manish M Sood  4   7 , Surapon Nochaiwong  8   9 ; Thai Renal Outcomes Research (THOR) Investigators
Affiliations
Multicenter Study

Changes in serum albumin concentrations during transition to dialysis and subsequent risk of peritonitis after peritoneal dialysis initiation: a retrospective cohort study

Kajohnsak Noppakun et al. J Nephrol. 2020 Dec.

Abstract

Background: Evidence shows that lower serum albumin concentrations are associated with the risk of peritoneal dialysis (PD)-related peritonitis. However, little is known regarding its relationship and magnitude of change before PD initiation and peritonitis risk.

Methods: We performed a multicenter retrospective cohort study on 1169 adult cases of PD in Thailand. The associations of serum albumin at concentration (< 2.5, 2.5-3.5, > 3.5 [reference] g/dL) and changes (unchanged + 0.1 to - 0.1 [reference], decrease or increase > 0.1 g/dL) over 3- and 6-month before PD initiation with PD-related peritonitis were examined. Time-to-first and longitudinal rates of peritonitis were examined using the multivariable Cox proportional hazards model and Poisson regression analyses, respectively.

Results: At baseline PD initiation, patients with serum albumin concentration < 2.5 and 2.5-3.5 g/dL had an adjusted hazard ratio (HR) of 1.69 and 2.0 times higher peritonitis (vs. > 3.5 g/dL), respectively. Compared to the unchanged group, patients with a decrease and increase in serum albumin concentrations during transitioning to dialysis were significantly associated with higher and lower risk of peritonitis, adjusted HR of 2.25 (95% confidence interval [CI] 1.85-2.75) and 0.53 (95% CI 0.42-0.68) over three-month, and 1.43 (95% CI 1.15-1.79) and 0.64 (95% CI 0.52-0.79) over six-month, respectively. Similar trends of longitudinal rates of serum albumin concentrations and peritonitis risk were observed.

Conclusions: Serum albumin concentrations at PD initiation and its magnitude of change during the transition to dialysis are strongly associated with subsequent risk of peritonitis. Further studies are required on strategies modifying serum albumin concentration during the transition to PD.

Keywords: Infection; Peritoneal dialysis; Peritonitis; Serum albumin; Transitioning.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Cho Y, Johnson DW (2014) Peritoneal dialysis-related peritonitis: towards improving evidence, practices, and outcomes. Am J Kidney Dis 64(2):278–289. https://doi.org/10.1053/j.ajkd.2014.02.025 - DOI - PubMed
    1. Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, Fish DN, Goffin E, Kim YL, Salzer W, Struijk DG, Teitelbaum I, Johnson DW (2016) ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int 36(5):481–508. https://doi.org/10.3747/pdi.2016.00078 - DOI - PubMed - PMC
    1. Ghali JR, Bannister KM, Brown FG, Rosman JB, Wiggins KJ, Johnson DW, McDonald SP (2011) Microbiology and outcomes of peritonitis in Australian peritoneal dialysis patients. Perit Dial Int 31(6):651–662. https://doi.org/10.3747/pdi.2010.00131 - DOI - PubMed
    1. Boudville N, Kemp A, Clayton P, Lim W, Badve SV, Hawley CM, McDonald SP, Wiggins KJ, Bannister KM, Brown FG, Johnson DW (2012) Recent peritonitis associates with mortality among patients treated with peritoneal dialysis. J Am Soc Nephrol 23(8):1398–1405. https://doi.org/10.1681/asn.2011121135 - DOI - PubMed - PMC
    1. Pecoits-Filho R, Yabumoto FM, Campos LG, Moraes TP, Figueiredo AE, Olandoski M, Shimakura SE, Barretti P (2018) Peritonitis as a risk factor for long-term cardiovascular mortality in peritoneal dialysis patients: The case of a friendly fire? Nephrology (Carlton) 23(3):253–258. https://doi.org/10.1111/nep.12986 - DOI

Publication types

LinkOut - more resources