Variation in Peritoneal Dialysis-Related Peritonitis Outcomes and Treatment Practices: Results from the Peritoneal Dialysis Outcomes and Practice Patterns Study
Bibliographic record
Abstract
Background: Peritoneal dialysis (PD)-associated peritonitis is a leading cause of technique failure and transition to hemodialysis. In the Optimizing Peritonitis Prevention in The United States (OPPUS) study, we explored the impact of various patient, facility and treatment factors on the likelihood of cure following a peritonitis episode. Methods: Using Peritoneal Dialysis Outcomes and Practice Patterns Study phase 1 (2014-2017) data from Australia and New Zealand, Canada, Japan, Thailand, the UK, and the US, cure was defined as the absence of a peritonitis relapse or recurrence, PD catheter removal, transition to hemodialysis or death during the 50 days following a peritonitis episode. Multivariable logistic regression was used to test associations between cure and patient, facility, and treatment characteristics. Results: We identified 1677 peritonitis episodes in 1190 patients across 126 facilities. Overall, 63% of episodes resulted in a cure. Cure was associated with APD (OR v. CAPD=1.35, 95% CI 1.02-1.80), higher serum albumin (OR=1.04 per 0.1 g/dL, 95% CI=1.01, 1.06), facility icodextrin use (OR=1.06 per 10% greater icodextrin use, 95% CI = 1.01-1.12), and aminoglycoside use for Gram-negative peritonitis (OR v. ceftazidime=3.10, 95% CI=1.02, 9.36). Prior peritonitis (OR v. no prior peritonitis episodes during follow-up=0.84, 95% CI=0.74, 0.97) and concomitant exit-site infection (OR= 0.42, 95% CI=0.28, 0.63) were associated with lower cure odds. Higher odds of peritonitis relapse were seen among patients with greater residual urine volume (OR= 1.14 per 200 ml, 95% CI=1.07, 1.22). Conclusions: Different characteristics and management practices can impact the likelihood of cure following a peritonitis episode. Our findings can inform future guidelines in addressing the effect of different modifiable patient, facility, and treatment factors on reducing morbidity associated with PD peritonitis. Funding: Other NIH Support - Agency for Healthcare Research and Quality (AHRQ)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".