The Association of Individual and Regional Socioeconomic Status on Initial Peritonitis and Outcomes in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Study

• Published in: Peritoneal dialysis international Vol. 36; no. 4; pp. 395 - 401
• Main Authors: Wang, Qin, Hu, Ke-Jie, Ren, Ye-Ping, Dong, Jie, Han, Qing-Feng, Zhu, Tong-Ying, Chen, Jiang-Hua, Zhao, Hui-Ping, Chen, Meng-Hua, Xu, Rong, Wang, Yue, Hao, Chuan-Ming, Zhang, Xiao-Hui, Wang, Mei, Tian, Na, Wang, Hai-Yan
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.07.2016; Multimed Inc
• Subjects: Adult; Aged; China; Educational Status; Female; Humans; Kaplan-Meier Estimate; Kidney Failure, Chronic - therapy; Logistic Models; Male; Middle Aged; Original; Peritoneal Dialysis - adverse effects; Peritonitis - epidemiology; Propensity Score; Retrospective Studies; Risk Factors; Social Class; Treatment Outcome; propensity score matching; peritoneal dialysis; socioeconomic status; Initial peritonitis
• ISSN: 0896-8608; 1718-4304
• DOI: 10.3747/pdi.2015.00100

Background Research indicates that the socioeconomic status (SES) of individuals and the area where they live are related to initial peritonitis and outcomes in peritoneal dialysis (PD). We conducted a retrospective, multi-center cohort study in China to examine these associations. Methods Data on 2,171 PD patients were collected from 7 centers, including baseline demographic, socioeconomic, and laboratory data. We explored the potential risk factors for initial peritonitis and outcomes using univariate Cox regression and unadjusted binary logistic regression. Then, we used propensity score matching to balance statistically significant risk factors for initial peritonitis and outcomes, and Kaplan-Meier survival analysis to compare differences in peritonitis-free rates between different groups of participants after matching. Results A total of 563 (25.9%) initial episodes of peritonitis occurred during the study period. The Kaplan-Meier peritonitis-free rate curve showed high-income patients had a significantly lower risk than low-income patients (p = 0.007) after matching for age, hemoglobin, albumin, and regional SES and PD center. The risk of treatment failure was significantly lower in the high-income than the low-income group after matching for the organism causing peritonitis and PD center: odds ratio (OR) = 0.27 (0.09 – 0.80, p = 0.018). Regional SES and education were not associated with initial peritonitis and outcomes. Conclusions Our study demonstrates low individual income is a risk factor for the initial onset of peritonitis and treatment failure after initial peritonitis.