Risk factors for subsequent recurrent, relapsing, and repeat peritonitis in peritoneal dialysis
Abstract
Background: Peritoneal dialysis (PD)-associated peritonitis may be followed by recurrent, relapsing, or repeat episodes, but factors associated with these subsequent phenotypes remain incompletely defined.
Methods: We conducted a 16-year episode-based study of PD-associated peritonitis. Episodes after which PD was not continued were excluded, and outcomes were defined by the next peritonitis episode. The broader outcome was subsequent recurrent/relapsing/repeat peritonitis, and the narrower outcome was subsequent relapsing/repeat peritonitis. Patient-level and PD prescription-related factors were evaluated for the broader outcome, whereas acute microbiology, antibiotic-management, and severity factors were evaluated for the narrower outcome using logistic generalized estimating equation models. Cross-outcome analyses evaluated both predictor domains against both outcomes.
Results: Among 385 PD-associated peritonitis episodes from 216 patients, 275 episodes from 152 patients were included. Subsequent recurrent/relapsing/repeat peritonitis occurred after 63 episodes. Male sex was associated with lower odds of this outcome, whereas diabetes mellitus, current recurrent/relapsing/repeat phenotype, fewer automated PD treatment days, and greater manual exchange burden were associated with higher odds. However, the two prescription measures were strongly inversely correlated, and neither remained significant when mutually adjusted. Subsequent relapsing/repeat peritonitis occurred after 57 episodes. Ineffective initial antibiotic therapy and delayed adequate antibiotic therapy were associated with higher odds. Organism group and acute severity markers were not significantly associated with this outcome after adjustment. Cross-outcome analyses were broadly compatible with the main findings.
Conclusions: Patient vulnerability, recent episode history, PD prescription-related patterns, and antibiotic-management factors were associated with subsequent peritonitis phenotypes among patients who continued PD. These findings may inform post-peritonitis risk assessment.
Related
- Peritoneal dialysis-associated peritonitis caused by Ureaplasma urealyticum : A case report
- Peritoneal Dialysis-Associated Peritonitis due to Pasteurella multocida: A Rare Case of Stray-Animal Exposure and Fluoroquinolone Resistance
- Clinical characteristics and preliminary discriminatory value of low triiodothyronine syndrome in patients with peritoneal dialysis-associated peritonitis : A cross-sectional study
- Peritonitis following subcutaneous embedding of peritoneal dialysis catheters at PD discontinuation: two cases within a six-patient institutional series and a literature review
- Successful Treatment of an Atypical Mycobacterial Exit Site Infection in a Patient on Peritoneal Dialysis: A Case Report
BibTeX
@article{shih2026risk,
title = {{Risk factors for subsequent recurrent, relapsing, and repeat peritonitis in peritoneal dialysis}},
author = {Hong-Mou Shih and Cheng-Jui Lin and Yi-Zhen Lu and Yu-Wen Hsueh and Chih-Jen Wu and Chi-Feng Pan},
journal = {Clinical Kidney Journal},
year = {2026},
month = oct,
doi = {10.1093/ckj/sfag352},
url = {https://doi.org/10.1093/ckj/sfag352},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Risk factors for subsequent recurrent, relapsing, and repeat peritonitis in peritoneal dialysis
AU - Hong-Mou Shih
AU - Cheng-Jui Lin
AU - Yi-Zhen Lu
AU - Yu-Wen Hsueh
AU - Chih-Jen Wu
AU - Chi-Feng Pan
PY - 2026
DA - 2026/10/05
JO - Clinical Kidney Journal
DO - 10.1093/ckj/sfag352
UR - https://doi.org/10.1093/ckj/sfag352
AB - Background: Peritoneal dialysis (PD)-associated peritonitis may be followed by recurrent, relapsing, or repeat episodes, but factors associated with these subsequent phenotypes remain incompletely defined. Methods: We conducted a 16-year episode-based study of PD-associated peritonitis. Episodes after which PD was not continued were excluded, and outcomes were defined by the next peritonitis episode. The broader outcome was subsequent recurrent/relapsing/repeat peritonitis, and the narrower outcome was subsequent relapsing/repeat peritonitis. Patient-level and PD prescription-related factors were evaluated for the broader outcome, whereas acute microbiology, antibiotic-management, and severity factors were evaluated for the narrower outcome using logistic generalized estimating equation models. Cross-outcome analyses evaluated both predictor domains against both outcomes. Results: Among 385 PD-associated peritonitis episodes from 216 patients, 275 episodes from 152 patients were included. Subsequent recurrent/relapsing/repeat peritonitis occurred after 63 episodes. Male sex was associated with lower odds of this outcome, whereas diabetes mellitus, current recurrent/relapsing/repeat phenotype, fewer automated PD treatment days, and greater manual exchange burden were associated with higher odds. However, the two prescription measures were strongly inversely correlated, and neither remained significant when mutually adjusted. Subsequent relapsing/repeat peritonitis occurred after 57 episodes. Ineffective initial antibiotic therapy and delayed adequate antibiotic therapy were associated with higher odds. Organism group and acute severity markers were not significantly associated with this outcome after adjustment. Cross-outcome analyses were broadly compatible with the main findings. Conclusions: Patient vulnerability, recent episode history, PD prescription-related patterns, and antibiotic-management factors were associated with subsequent peritonitis phenotypes among patients who continued PD. These findings may inform post-peritonitis risk assessment.
SN - 2048-8505
SN - 2048-8513
ER -