TY - JOUR
T1 - The relationship between body mass index and organism-specific peritonitis
AU - Jegatheesan, Dev
AU - Johnson, David W.
AU - Cho, Yeoungjee
AU - Pascoe, Elaine M.
AU - Darssan, Darsy
AU - Htay, Htay
AU - Hawley, Carmel
AU - Clayton, Philip A.
AU - Borlace, Monique
AU - Badve, Sunil V.
AU - Sud, Kamal
AU - Boudville, Neil
AU - McDonald, Stephen P.
AU - Nadeau-Fredette, Annie Claire
N1 - Funding Information:
DJ has received consultancy fees, research grants, speaker’s honoraria and travel sponsorships for Baxter Healthcare and Fresenius Medical Care. He is supported by a National Health and Medical Research Council Practitioner Fellowship. YC has received research grants from Fresenius Medical Care and Baxter Healthcare. She is supported by a National Health and Medical Research Council Early Career Fellowship. CH has previously received research grants, and travel sponsorships from Baxter Healthcare and Fresenius Medical Care. KS has received speaker’s honoraria from Baxter Healthcare, Roche, Amgen, and Boehringer Ingelheim and conference or meeting sponsorships from Shire, Roche, Boehringer Ingelheim, Amgen, Sanofi and Novartis. ACNF has received research grants from Baxter Healthcare and consultancy fees from Fresenius Medical Care. All other authors have no conflict of interest to declare.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - ♦ Background: Obesity is increasingly prevalent worldwide, and a greater number of patients initiate renal replacement therapy with a high body mass index (BMI). This study aimed to evaluate the association between BMI and organism-specific peritonitis. ♦ Methods: All adult patients who initiated peritoneal dialysis (PD) in Australia between January 2004 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. The coprimary outcomes of this study were time to first organism-specific peritonitis episode, specifically gram-positive, gram-negative, culture-negative, and fungal. Secondary outcomes were individual rates of organism-specific peritonitis for the same 4 microbiological categories. ♦ Results: There were 7,381 peritonitis episodes among the 8,343 incident PD patients evaluated. After multivariable adjustment, obese patients (BMI 30 – 34.9 kg/m2) had an increased risk of fungal peritonitis (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.18 – 2.42), very obese patients (BMI ≥ 35 kg/ m2) had a significantly higher risk of gram-positive peritonitis (HR 1.15, 95% CI 1.02 – 1.30), while both obese and very obese patients experienced significantly higher risks of gram-negative peritonitis (HR 1.29, 95% CI 1.11 – 1.50 and HR 1.30, 95% CI 1.08 – 1.57, respectively) compared with patients with normal BMI (20 – 24.9 kg/m2). Obesity and severe obesity were independently associated with increased incidence rate ratios of all forms of organism-specific peritonitis with a non-significant trend for severe obesity and gram-negative peritonitis association. ♦ Conclusion: Among Australian patients, obesity and severe obesity are associated with significantly increased rates of gram-positive, gram-negative, fungal, and culture-negative peritonitis.
AB - ♦ Background: Obesity is increasingly prevalent worldwide, and a greater number of patients initiate renal replacement therapy with a high body mass index (BMI). This study aimed to evaluate the association between BMI and organism-specific peritonitis. ♦ Methods: All adult patients who initiated peritoneal dialysis (PD) in Australia between January 2004 and December 2013 were included. Data were accessed through the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. The coprimary outcomes of this study were time to first organism-specific peritonitis episode, specifically gram-positive, gram-negative, culture-negative, and fungal. Secondary outcomes were individual rates of organism-specific peritonitis for the same 4 microbiological categories. ♦ Results: There were 7,381 peritonitis episodes among the 8,343 incident PD patients evaluated. After multivariable adjustment, obese patients (BMI 30 – 34.9 kg/m2) had an increased risk of fungal peritonitis (adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.18 – 2.42), very obese patients (BMI ≥ 35 kg/ m2) had a significantly higher risk of gram-positive peritonitis (HR 1.15, 95% CI 1.02 – 1.30), while both obese and very obese patients experienced significantly higher risks of gram-negative peritonitis (HR 1.29, 95% CI 1.11 – 1.50 and HR 1.30, 95% CI 1.08 – 1.57, respectively) compared with patients with normal BMI (20 – 24.9 kg/m2). Obesity and severe obesity were independently associated with increased incidence rate ratios of all forms of organism-specific peritonitis with a non-significant trend for severe obesity and gram-negative peritonitis association. ♦ Conclusion: Among Australian patients, obesity and severe obesity are associated with significantly increased rates of gram-positive, gram-negative, fungal, and culture-negative peritonitis.
KW - Cohort studies
KW - Obesity
KW - Obesity/complica-tions
KW - Obesity/microbiology
KW - Peritoneal dialysis
KW - Predictors
KW - Registries
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85047856043&partnerID=8YFLogxK
U2 - 10.3747/pdi.2017.00188
DO - 10.3747/pdi.2017.00188
M3 - Article
C2 - 29848600
AN - SCOPUS:85047856043
VL - 38
SP - 206
EP - 214
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
SN - 0896-8608
IS - 3
ER -