Development of a clinical risk score system for peritoneal dialysis-associated peritonitis treatment failure

• Published in: BMC nephrology Vol. 24; no. 1; p. 229
• Main Authors: Mao, Yuhe, Xiao, Dan, Deng, Shengjing, Xue, Shaoqing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.08.2023; BioMed Central; BMC
• Subjects: Blood; Brain natriuretic peptide; C-reactive protein; Care and treatment; Comparative analysis; Complications and side effects; Contamination; Continuous ambulatory peritoneal dialysis; Diabetes; Dialysate; Effluents; Hemodialysis; Leukocytes; Medical prognosis; Medical protocols; Medical research; Medicine, Experimental; Natriuretic peptides; Nephrology; Normal distribution; Patients; Peritoneal dialysis; Peritoneal dialysis-associated peritonitis; Peritoneal fluid; Peritoneum; Peritonitis; Regression analysis; Risk factors; Risk score system; Statistical analysis; Treatment failure; Urea; Variables; Taiwan; China; Peritoneal dialysis-associated peritonitis; Treatment failure; Risk score system; Risk factors
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-023-03284-1

This study aimed to construct a clinical risk score system for peritoneal dialysis-associated peritonitis (PDAP) treatment failure to provide a theoretical basis for clinical workers. A total of 161 PDAP individuals admitted to our hospital were included, among whom 70 cases were in the treatment-improved group and 87 cases were in the treatment failure group. We compared the general condition, clinical manifestations, and laboratory examination indicators of the two groups of individuals, used multivariate logistic regression analysis to identify the factors influencing PDAP treatment failure, and developed a clinical risk score system. The diagnostic performance of the risk score system was evaluated utilizing the receiver operating characteristic (ROC) curve. Significant differences (P < 0.05) were observed between the two groups in terms of contamination, peritoneal fluid culture results, blood urea nitrogen (BUN) level, C-reactive protein (CRP) level, B-type natriuretic peptide (BNP) level, average residual urine (RU) volume, and urea clearance rate (UCR). Multivariate logistic regression analysis showed that BUN level, CRP level, BNP level, average RU volume, and UCR were independent risk factors affecting PDAP patient treatment outcomes (P < 0.05). The ROC curve analysis of the risk score system for predicting treatment failure in PDAP individuals showed an area under the curve of 0.895 [95% confidence interval (0.847-0.943)]. The optimal cut-off point was 2.5 points, with corresponding sensitivity and specificity of 88.5% and 74.3%, separately. BUN level, CRP level, BNP level, average RU volume, and UCR are independent risk factors for PDAP treatment failure. The clinical risk score system based on these five independent risk factors can accurately predict the risk of treatment failure in PDAP individuals.