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. 2024 Oct 3;14(1):22955.
doi: 10.1038/s41598-024-74205-x.

The impact of shortening patient-doctor contact duration on early peritoneal dialysis-related infections

Jeong-Hoon Lim  1 , Yu Jin Seo  2 , Roberto Pecoits-Filho  3 , Brian Bieber  3 , Jeffrey Perl  4 , David W Johnson  5   6 , Hee-Yeon Jung  1 , Ji-Young Choi  1 , Jang-Hee Cho  1 , Chan-Duck Kim  1 , Kook-Hwan Oh  7 , Sun-Hee Park #  8   9 , Yong-Lim Kim #  10   11 ; PDOPPS Korea group
Collaborators, Affiliations

The impact of shortening patient-doctor contact duration on early peritoneal dialysis-related infections

Jeong-Hoon Lim et al. Sci Rep. .

Abstract

Early peritoneal dialysis (PD)-related infection is a severe complication. This study investigated the relationship between patient-doctor contact (PDC) duration and early PD-related infection. In the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) Korea, incident dialysis patients receiving PD were divided into two groups based on PDC duration (< 15 min versus ≥ 15 min), which was defined as the duration a nephrologist typically spends with a patient receiving PD during each visit according to the facility practice pattern. Early risks of PD-related infections, such as peritonitis and catheter-related infection (onset within 3 and 12 months of PD), were compared to the PDC duration using Cox regression. The study included 276 patients (184 [66.7%] in the shorter PDC group [< 15 min] and 92 [33.3%] in the longer PDC group [≥ 15 min]). The average age did not differ between the groups. The incidences of 3- and 12-month PD-related infections were significantly lower in the longer PDC group than in the shorter PDC group (3 months: 1.1% versus 9.8%, P = 0.007; 12 months: 9.8% versus 23.4%, P = 0.007). Longer PDC was independently associated with a lower risk of PD-related infections at 3 and 12 months (3 months: adjusted hazard ratio [aHR], 0.11; 95% confidence interval [CI], 0.02-0.85, P = 0.034; 12 months: aHR, 0.43; 95% CI 0.19-0.99, P = 0.048). Overall, a longer PDC duration was associated with a significantly lower risk of early PD-related infection.

Keywords: Catheter-related infection; PD-related infection; Patient–doctor contact hour; Peritoneal dialysis; Peritonitis.

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Conflict of interest statement

David Johnson has received consultancy fees, research grants, speaker’s honoraria and travel sponsorships from Baxter Healthcare and Fresenius Medical Care, consultancy fees from Astra Zeneca, Bayer, and AWAK, speaker’s honoraria from ONO and Boehringer Ingelheim & Lilly, and travel sponsorships from Ono and Amgen. He is a current recipient of an Australian National Health and Medical Research Council Leadership Investigator Grant. Jeffrey Perl reports support from AHRQ and Arbor Research Collaborative for Health. He has received consulting fees from Astra Zeneca, Baxter Healthcare, GSK, Otsuka, Amgen, Pfizer, and Bayer; honoraria from Baxter Healthcare, FMC, DaVita Healthcare, Innovative Renal Care, AMGEN, and US Renal Care; and owns stock in LiberDi. The remaining authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for early PD-related infections. (A) PD-related infection-free survival within 3 months. (B) PD-related infection-free survival within 12 months. PD peritoneal dialysis, PDC patient–doctor contact.
Fig. 2
Fig. 2
Subgroup Cox regression analysis of PD-related infections within 12 months. PD peritoneal dialysis, PDC patient–doctor contact, HR hazard ratio, CI confidence interval, DM diabetes mellitus.
Fig. 3
Fig. 3
Study flowchart. PD peritoneal dialysis, PDOPPS Peritoneal dialysis outcomes and practice patterns study.
See this image and copyright information in PMC

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