Predictors and Complications of Post Kidney Transplant Leukopenia

Background: Leukopenia occurs frequently following kidney transplantation and is associated with adverse clinical outcomes including increased infectious risk. In this study we sought to characterize the causes and complications of leukopenia following kidney transplantation. Methods: In a cohort of adult patients (≥18 years) who underwent kidney transplant from Jan 2006-Dec 2017, we used univariable Cox proportional Hazards models to identify predictors of post-transplant leukopenia (WBC < 3500 mm3). Factors associated with post-transplant leukopenia were then included in a multivariable backwards stepwise selection process to create a prediction model for the outcome of interest. Cox regression analyses were subsequently used to determine if post-transplant leukopenia was associated with complications. Results: Of 388 recipients, 152 (39%) developed posttransplant leukopenia. Factors associated with leukopenia included antithymocyte globulin as induction therapy (HR 3.32, 95% CI 2.25-4.91), valganciclovir (HR 1.84, 95% CI 1.25-2.70), tacrolimus (HR 3.05, 95% CI 1.08-8.55), prior blood transfusion (HR 1.17 per unit, 95% CI 1.09- 1.25), and donor age (HR 1.02 per year, 95% CI 1.00-1.03). Cytomegalovirus infection occurred in 26 patients with leukopenia (17.1%). Other than cytomegalovirus, leukopenia was not associated with posttransplant complications. Conclusion: Leukopenia commonly occurred posttransplant and was associated with modifiable and non-modifiable pretransplant factors.

Download Full-text

Frailty and Access to Kidney Transplantation

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.12921118 ◽

2019 ◽

Vol 14 (4) ◽

pp. 576-582 ◽

Cited By ~ 22

Author(s):

Christine E. Haugen ◽

Nadia M. Chu ◽

Hao Ying ◽

Fatima Warsame ◽

Courtenay M. Holscher ◽

...

Keyword(s):

Kidney Transplantation ◽

Confidence Interval ◽

Kidney Transplant ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Activity Level ◽

Frailty Status ◽

Poor Cognitive Function ◽

Transplant Candidates ◽

Poor Outcomes

Background and objectivesFrailty, a syndrome distinct from comorbidity and disability, is clinically manifested as a decreased resistance to stressors and is present in up to 35% of patient with ESKD. It is associated with falls, hospitalizations, poor cognitive function, and mortality. Also, frailty is associated with poor outcomes after kidney transplant, including delirium and mortality. Frailty is likely also associated with decreased access to kidney transplantation, given its association with poor outcomes on dialysis and post-transplant. Yet, clinicians have difficulty identifying which patients are frail; therefore, we sought to quantify if frail kidney transplant candidates had similar access to kidney transplantation as nonfrail candidates.Design, setting, participants, & measurementsWe studied 7078 kidney transplant candidates (2009–2018) in a three-center prospective cohort study of frailty. Fried frailty (unintentional weight loss, grip strength, walking speed, exhaustion, and activity level) was measured at outpatient kidney transplant evaluation. We estimated time to listing and transplant rate by frailty status using Cox proportional hazards and Poisson regression, adjusting for demographic and health factors.ResultsThe mean age was 54 years (SD 13; range, 18–89), 40% were women, 34% were black, and 21% were frail. Frail participants were almost half as likely to be listed for kidney transplantation (hazard ratio, 0.62; 95% confidence interval, 0.56 to 0.69; P<0.001) compared with nonfrail participants, independent of age and other demographic factors. Furthermore, frail candidates were transplanted 32% less frequently than nonfrail candidates (incidence rate ratio, 0.68; 95% confidence interval, 0.58 to 0.81; P<0.001).ConclusionsFrailty is associated with lower chance of listing and lower rate of transplant, and is a potentially modifiable risk factor.

Download Full-text

The Association between Homocysteinemia and Mortality in Pre-dialysis CKD patients: A Propensity-Score Matched Analysis Using NHANES-National Death Index Link

10.21203/rs.3.rs-948936/v1 ◽

2021 ◽

Author(s):

Je Hun Song ◽

Hyuk Huh ◽

Eunjin Bae ◽

Jeonghwan Lee ◽

Jung Pyo Lee ◽

...

Keyword(s):

Risk Factor ◽

Propensity Score ◽

Proportional Hazards ◽

Cox Regression ◽

Cox Proportional Hazards ◽

Mortality Data ◽

Protein Energy Wasting ◽

Cox Regression Analysis ◽

Cox Proportional Hazards Models ◽

All Cause Mortality

Abstract Background: Hyperhomocysteinemia (HHcy) is considered a risk factor for cardiovascular disease (CVD) including chronic kidney disease (CKD). In this study, we investigated the association between serum homocysteine (Hcy) level and mortality according to the presence of CKD.Methods: Our study included data of 9,895 participants from the 1996–2016 National Health and Nutrition Examination Surveys (NHANES). Moreover, linked mortality data were included and classified into four groups according to the Hcy level. Multivariable-adjusted Cox proportional hazards models using propensity-score were used to examine dose-response associations between Hcy level and mortality.Results: Of 9,895 participants, 1032 (21.2%) participants were diagnosed with CKD. In a multivariate Cox regression analysis including all participants, Hcy level was associated with all-cause mortality, compared with the 1st quartile in Model 3 (2nd quartile: hazard ratio (HR) 1.751, 95% confidence interval (CI) 1.348-2.274, p<0.001; 3rd quartile: HR 2.220, 95% CI 1.726-2.855, p<0.001; 4th quartile: HR 3.776, 95% CI 2.952-4.830, p<0.001). In the non-CKD group, there was a significant association with all-cause mortality; however, this finding was not observed in the CKD group. The observed pattern was similar after propensity score matching. In the non-CKD group, overall mortality increased in proportion to Hcy concentration (2nd quartile: HR 2.195, 95% CI 1.299-3.709, p = 0.003; 3rd quartile: HR 2.607, 95% CI 1.570-4.332, p<0.001; 4th quartile: HR 3.720, 95% CI 2.254-6.139, p<0.001). However, the risk of all-cause mortality according to the quartile of Hcy level did not increase in the CKD groupConclusion: This study found a correlation between the Hcy level and mortality rate only in the non-CKD group. This altered risk factor patterns may be attributed to protein-energy wasting or chronic inflammation status that is accompanied by CKD.

Download Full-text

Factors associated with the duration of hospitalisation among COVID-19 patients in Vietnam: A survival analysis

Epidemiology and Infection ◽

10.1017/s0950268820001259 ◽

2020 ◽

Vol 148 ◽

Cited By ~ 4

Author(s):

Pham Quang Thai ◽

Do Thi Thanh Toan ◽

Dinh Thai Son ◽

Hoang Thi Hai Van ◽

Luu Ngoc Minh ◽

...

Keyword(s):

Regression Model ◽

Median Duration ◽

Symptom Onset ◽

Proportional Hazards ◽

Cox Regression ◽

Length Of Hospital Stay ◽

Cox Proportional Hazards ◽

Factors Associated ◽

Hospitalised Patients ◽

Hospital Stays

Abstract Background The median duration of hospital stays due to COVID-19 has been reported in several studies on China as 10−13 days. Global studies have indicated that the length of hospitalisation depends on different factors, such as the time elapsed from exposure to symptom onset, and from symptom onset to hospital admission, as well as specificities of the country under study. The goal of this paper is to identify factors associated with the median duration of hospital stays of COVID-19 patients during the second COVID-19 wave that hit Vietnam from 5 March to 8 April 2020. Method We used retrospective data on 133 hospitalised patients with COVID-19 recorded over at least two weeks during the study period. The Cox proportional-hazards regression model was applied to determine the potential risk factors associated with length of hospital stay. Results There were 65 (48.9%) females, 98 (73.7%) patients 48 years old or younger, 15 (11.3%) persons with comorbidities, 21 (16.0%) severely ill patients and 5 (3.8%) individuals with life-threatening conditions. Eighty-two (61.7%) patients were discharged after testing negative for the SARS-CoV-2 virus, 51 were still in the hospital at the end of the study period and none died. The median duration of stay in a hospital was 21 (IQR: 16–34) days. The multivariable Cox regression model showed that age, residence and sources of contamination were significantly associated with longer duration of hospitalisation. Conclusion A close look at how long COVID-19 patients stayed in the hospital could provide an overview of their treatment process in Vietnam, and support the country's National Steering Committee on COVID-19 Prevention and Control in the efficient allocation of resources over the next stages of the COVID-19 prevention period.

Download Full-text

Benefits of a Secondary Prevention Program in Suicide

Crisis ◽

10.1027/0227-5910/a000388 ◽

2016 ◽

Vol 37 (4) ◽

pp. 281-289 ◽

Cited By ~ 5

Author(s):

Adriana Farré ◽

Maria J. Portella ◽

Luis De Angel ◽

Ana Díaz ◽

Javier de Diego-Adeliño ◽

...

Keyword(s):

Secondary Prevention ◽

Suicide Prevention ◽

Suicidal Behavior ◽

Prevention Program ◽

Proportional Hazards ◽

Cox Regression ◽

Cox Proportional Hazards ◽

Control Group ◽

Suicide Behavior ◽

Cox Proportional Hazards Models

Abstract. Background: The effectiveness of suicide intervention programs has not been assessed with experimental designs. Aim: To determine the risk of suicide reattempts in patients engaged in a secondary prevention program. Method: We included 154 patients with suicidal behavior in a quasi-experimental study with a nontreatment concurrent control group. In all, 77 patients with suicidal behavior underwent the Suicide Behavior Prevention Program (SBPP), which includes specialized early assistance during a period of 3–6 months. A matched sample of patients with suicidal behavior (n = 77) was selected without undergoing any specific suicide prevention program. Data on sociodemographics, clinical characteristics, and suicidal behavior were collected at baseline (before SBPP) and at 12 months. Results: After 12 months, SBPP patients showed a 67% lower relative risk of reattempt (χ2 = 11.75, p = .001, RR = 0.33 95% CI = 0.17–0.66). Cox proportional hazards models revealed that patients under SBPP made a new suicidal attempt significantly much later than control patients did (Cox regression = 0.293, 95% CI = 0.138–0.624, p = .001). The effect was even stronger among first attempters. Limitations: Sampling was naturalistic and patients were not randomized. Conclusion: The SBPP was effective in delaying and preventing suicide reattempts at least within the first year after the suicide behavior. In light of our results, implementation of suicide prevention programs is strongly advisable.

Download Full-text

Prognostic factors and survival of patients with brain metastasis (BM) from breast cancer (BC) who underwent craniotomy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e22017 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e22017-e22017

Author(s):

Jose Pablo Leone ◽

Diana E. Cunningham ◽

Adrian Lee ◽

Rohit Bhargava ◽

Ronald L. Hamilton ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Proportional Hazards ◽

Cox Regression ◽

Primary Diagnosis ◽

Cox Proportional Hazards ◽

Factors Associated ◽

Brain Radiotherapy ◽

Whole Brain Radiation ◽

First Recurrence

e22017 Background: BC is the second most frequent cause of BM after lung cancer, with metastases occurring in 10-16% of all patients. BM in patients with BC is a catastrophic event that results in poor prognosis. Identification of prognostic factors associated with breast cancer brain metastases (BCBM) could help to identify patients at risk. The aim of this study was to assess clinical characteristics, prognostic factors and survival of patients with BCBM who had craniotomy and resection in a series of patients treated with modern multimodality therapy. Methods: We analyzed 42 patients with BCBM who underwent resection. Patients were diagnosed with BC between April 1994 and May 2010. Cox proportional hazards regression was selected to describe factors associated with time to BM, survival from the date of first recurrence, and overall survival (OS). Results: Median age was 51 years (range 24-74). Median follow-up was 4.2 years (range 0.6-18.5). The mean time to BM from primary diagnosis was 49 months (range 0-206.22). Patients had a median of 2 BM with a median size of 3.25 cm. The proportion of the biological subtypes of BC was ER+/HER2- 25%, ER+/HER2+ 15%, ER-/HER2+ 30% and ER-/HER2- 30%. Brain radiotherapy was given to 28 patients, of which 10 had stereotactic radiosurgery, 7 whole brain radiation, and 11 both. Median OS from the date of primary diagnosis was 5.74 years. Median survival after diagnosis of BM was 1.33 years. In multivariate Cox regression analyses, stage was the only factor associated with shorter time to the development of BM (P=0.059), whereas age was the only factor associated with survival from the date of recurrence (P=0.027) and with OS (P=0.037). Controlling for age and stage, neither the biological subtype of cancer, the radiation modality nor the site of first recurrence showed any impact on survival. Conclusions: Stage at primary diagnosis correlated with shorter time to the development of BM, while age at diagnosis was associated with shorter survival in BCBM. None of the other clinical factors had influence on survival.

Download Full-text

Impact of clinical and pathological variables on stage I non-small cell lung cancer outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e21071 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e21071-e21071

Author(s):

Matthew C Lee ◽

Dimitre C Stefanov ◽

Mallorie B Angert ◽

Erica C Cohn ◽

Nina Kohn ◽

...

Keyword(s):

Proportional Hazards ◽

Cox Regression ◽

Neuroendocrine Differentiation ◽

Clinical Importance ◽

Recurrence Risk ◽

Cox Proportional Hazards ◽

Stage I ◽

Rank Test ◽

Histological Features ◽

Cox Proportional Hazards Models

e21071 Background: Stage I patients (pts) have 5-year survival ranging 50-75% suggesting heterogeneity within. While American Joint Committee on Cancer 8th edition upstages tumors with visceral pleural invasion (VPI) to IB, other histological features namely lymphovascular invasion (LVI), micropapillary pattern (MIP), spread through airspace (STAS) & neuroendocrine differentiation (NE) may also affect prognosis. This retrospective single institution study evaluated influence of these factors along with pt variables age, gender, smoking, Charleston comorbidity index (CCI) & chemotherapy (CT) on recurrence & mortality. Methods: 351 resected stage I cases from 2015-2019 were included. Data was summarized as means (standard deviation/SD) or percentages. Association between variables & outcomes (measured from diagnosis till event or last visit if no event) were investigated using Univariate & Multiple Cox proportional hazards models. Survival curves were compared using the Log-Rank test when the assumption for the proportional hazards was not satisfied. All predictors were included in the multiple Cox regression models based on their clinical importance. P < 0.05 was considered statistically significant. SAS 9.4 (SAS Institute, Cary, NC) was used for the analysis. Results: Mean age was 69.62 years (9.83). Majority were female (57.3%), smokers (76.9%), & had adenocarcinoma (AC) (78.6%). 39% had COPD & mean CCI was 6.3 (1.74). 193 (55%) pts had lobectomy or larger procedure while 158 (45%) had sub-lobar resection. 45 (12.8%) pts received CT. Recurrence & death occurred in 33 (9.4%) & 15 (4.3%) pts respectively. Univariate models indicated higher recurrence risk with NE (HR = 4.18 95% CI 1.47-11.9, p = 0.0075), LVI (HR = 2.68, 95% CI 1.03-6.94, p = 0.0423), COPD (HR = 3.28 95% CI 1.56-6.9, p = 0.0017), age (HR = 1.05 95% CI 1.01-1.09, p = 0.0212), & CCI (HR = 1.57 95% CI 1.35-1.83, p < .0001). CT was also associated with increased recurrence risk (HR = 8.61, 95% CI 4.28-17.33, p < .0001). Multivariable model for recurrence retained significance for CT & CCI. Age (HR = 1.07 95% CI 1.01-1.14, p = 0.0312), CCI (HR = 1.27 95 % CI 1.02-1.59, p = 0.0347) were associated with mortality in univariate models. Multivariate analysis for mortality wasn’t feasible due to few events. Conclusions: Histological features other than VPI may be associated with recurrence. Pts who received CT had increased recurrence but they possibly had multiple risk factors or other adverse features not assessed here. Limitations included retrospective nature, limited sample size & small number of events.

Download Full-text

Abstract 15777: Induction Immunosuppression is Associated With a Lower Incidence of Post-transplant Diabetes Mellitus in Heart Transplant Recipients: A Propensity-adjusted Analysis

Circulation ◽

10.1161/circ.142.suppl_3.15777 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Suruchi K Gupta ◽

Elizabeth Mostofsky ◽

Wenyuan Li ◽

Ali Hage ◽

Shweta R Motiwala ◽

...

Keyword(s):

Diabetes Mellitus ◽

Heart Transplant ◽

Propensity Scores ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Transplant Recipients ◽

Post Transplant ◽

Adjusted Analysis ◽

Cox Proportional Hazards Models ◽

Heart Transplant Recipients

Introduction: Post-transplant diabetes mellitus (PTDM) is a common complication among heart transplant recipients resulting in heightened risk of diabetes-related complications and death. While there is evidence that certain maintenance immunosuppression drugs like tacrolimus increase the risk of PTDM, it is not known whether induction immunosuppression does the same. We therefore evaluated whether induction immunosuppression in the early post-transplant period with IL-2 inhibitors, alemtuzumab or anti-thymocyte globulin is associated with PTDM after accounting for potential confounding by indication. Methods: Using data from the Scientific Registry of Transplant Recipients, we conducted a cohort study of 23,946 US adults who received a heart transplant in January 2008-December 2018. PTDM was defined as new diagnosis of diabetes at any time 6 months after transplant. We excluded patients with prior organ transplants and diabetes. We used logistic regression to construct propensity scores for predictors of induction immunosuppression and risk factors for PTDM including demographic, clinical and immunologic factors, pre-transplant therapies, steroids, functional status, and transplant year. We estimated the effect of induction immunosuppression in propensity-adjusted Cox proportional hazards models and produced fully adjusted Kaplan-Meier curves using inverse probability of treatment weights. Results: The average age was 54 (SD=12.5) years, 26% were female and 12,303 (51%) received induction immunosuppression. Over 84,969 person-years, 2,678 (11%) developed PTDM (32 cases/1,000 person-years). In the propensity-adjusted analysis, induction immunosuppression was associated with a 20% lower rate of PTDM (Figure 1; hazard ratio=0.80, 95% confidence interval 0.74-0.87). Conclusions: Adult heart transplant recipients who received induction immunosuppression had a 20% lower rate of PTDM compared to those who did not receive it.

Download Full-text

Adjuvant Radiation in Older Patients With Glioblastoma: A Retrospective Single Institution Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.631618 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jessica W. Lee ◽

John P. Kirkpatrick ◽

Frances McSherry ◽

James E. Herndon ◽

Eric S. Lipp ◽

...

Keyword(s):

Older Patients ◽

Proportional Hazards ◽

Hospice Care ◽

Cox Proportional Hazards ◽

Trend Test ◽

Adjuvant Radiation ◽

Factors Associated ◽

Cox Proportional Hazards Models ◽

Short Course ◽

Selection Of

ObjectivesStandard 6-week and hypofractionated 3-week courses of adjuvant radiation therapy (RT) are both options for older patients with glioblastoma (GBM), but deciding the optimal regimen can be challenging. This analysis explores clinical factors associated with selection of RT course, completion of RT, and outcomes following RT.Materials and MethodsThis IRB-approved retrospective analysis identified patients ≥70 years old with GBM who initiated adjuvant RT at our institution between 2004 and 2016. We identified factors associated with standard or hypofractionated RT using the Cochran-Armitage trend test, estimated time-to-event endpoints using the Kaplan-Meier method, and found predictors of overall survival (OS) using Cox proportional hazards models.ResultsSixty-two patients with a median age of 74 (range 70–90) initiated adjuvant RT, with 43 (69%) receiving standard RT and 19 (31%) receiving hypofractionated RT. Selection of short-course RT was associated with older age (p = 0.04) and poor KPS (p = 0.03). Eight (13%) patients did not complete RT, primarily for hospice care due to worsening symptoms. After a median follow-up of 37 months, median OS was 12.3 months (95% CI 9.0–15.1). Increased age (p < 0.05), poor KPS (p < 0.0001), lack of MGMT methylation (p < 0.05), and lack of RT completion (p < 0.0001) were associated with worse OS on multivariate analysis. In this small cohort, GTV size and receipt of standard or hypofractionated RT were not associated with OS.ConclusionsIn this cohort of older patients with GBM, age and KPS was associated with selection of short-course or standard RT. These regimens had similar OS, though a subset of patients experienced worsening symptoms during RT and discontinued treatment. Further investigation into predictors of RT completion and survival may help guide adjuvant therapies and supportive care for older patients.

Download Full-text

Effect of Sedative-Hypnotic Medicines on Mortality in Peritoneal Dialysis Patients with Sleep Disorders: A Retrospective Cohort Study

Blood Purification ◽

10.1159/000484922 ◽

2017 ◽

Vol 45 (1-3) ◽

pp. 95-101

Author(s):

Ying Zhou ◽

Peiran Yin ◽

Bin Li ◽

Jianying Li ◽

Naya Huang ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Sleep Disorders ◽

Older Patients ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Dialysis Patients ◽

Factors Associated ◽

Cox Proportional Hazards Models ◽

Hypnotic Medication ◽

All Cause Mortality

Background: Sedative-hypnotic medication is widely used among continuous ambulatory peritoneal dialysis (CAPD) patients with sleep disorders; however, its effect on mortality has rarely been investigated. Methods: Logistic regression was employed to identify factors associated with sedative-hypnotic medication, whose effect on mortality was evaluated by Cox proportional hazards models. Results: A total of 146 CAPD patients with sleep disorders were recruited, of which 46 patients (31.5%) used either benzodiazepines or zolpidem. Sedative-hypnotic medication was more frequently used by older patients and those with longer duration of CAPD therapy and there was no significant association between sedative-hypnotic medicines and all-cause mortality after adjusting for age, gender, diabetes, cardiovascular disease, and duration of CAPD. Conclusion: Sedative-hypnotic medication was more often used by older patients and patients with a longer duration of CAPD. There was no association between these agents and all-cause mortality in CAPD patients with sleep disorders.

Download Full-text

High Intraperitoneal Interleukin-6 Levels Predict Peritonitis in Peritoneal Dialysis Patients: A Prospective Cohort Study

American Journal of Nephrology ◽

10.1159/000489271 ◽

2018 ◽

Vol 47 (5) ◽

pp. 317-324 ◽

Cited By ~ 2

Author(s):

Xiaoxiao Yang ◽

Yijing Tong ◽

Hao Yan ◽

Zhaohui Ni ◽

Jiaoqi Qian ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Prospective Study ◽

Interleukin 6 ◽

Proportional Hazards ◽

Cox Regression ◽

High Serum ◽

Cox Proportional Hazards ◽

First Episode ◽

Free Survival ◽

Cox Proportional Hazards Models

Background: To evaluate the predictive value of dialysate interleukin-6 (IL-6) representing local subclinical intraperitoneal inflammation for the development of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: Stable prevalent CAPD patients were enrolled in this prospective study. IL-6 concentration in the overnight effluent was determined and expressed as the IL-6 appearance rate (IL-6AR). Patients were divided into 2 groups according to the median of IL-6AR and prospectively followed up until the first episode of peritonitis, cessation of PD, or the end of the study (December 30, 2017). The utility of IL-6AR in predicting peritonitis-free survival was analyzed using the Kaplan-Meier and Cox proportional hazards models. Results: A total of 149 patients were enrolled, including 72 males (48%) with mean age 52.0 ± 13.6 years and median PD duration 26 (5.9–45.5) months. During follow-up, 7,923 patient months were observed and 154 episodes of peritonitis occurred in 82 patients. Previous peritonitis episodes were significantly associated with log dialysate IL-6AR levels (β = 0.187 [0.022–0.299], p = 0.023). Patients in the high IL-6AR group showed a significantly inferior peritonitis-free survival when compared with their counterparts in the low IL-6AR group (48.8 vs. 67.7 months, p = 0.026), as well as higher treatment failure percentage of peritonitis (20.3 vs. 9.3%, p = 0.049). A multivariate Cox regression showed that high dialysate IL-6AR (hazard ratio [HR] 1.247 [1.052–1.478]; p = 0.011) and high serum C-reactive protein (HR 1.072 [1.005–1.144]; p = 0.036) were independent risk factors for inferior peritonitis-free survival. Conclusion: This prospective study suggested that the intraperitoneal inflammation marker, dialysate IL-6 level, might be a potential predictor of peritonitis development in patients undergoing PD.

Download Full-text