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Lower Limb Ulcer Associated with Peritonitis in Patients Undergoing Peritoneal Dialysis

Authors Terada K, Aratani S, Hirama A, Kashiwagi T, Sakai Y

Received 5 December 2020

Accepted for publication 20 January 2021

Published 11 February 2021 Volume 2021:14 Pages 33—40


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Pravin Singhal

Kohsuke Terada, Sae Aratani, Akio Hirama, Tetsuya Kashiwagi, Yukinao Sakai

Department of Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

Correspondence: Yukinao Sakai
Department of Nephrology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
Tel +81-3-3822-2131 ext. 6496
Fax +81-3-3822-4865

Purpose: Peritoneal dialysis (PD)-related peritonitis and lower limb ulcer are the important complications in patients undergoing PD. Although the association between lower limb ulcer and peritonitis in patients undergoing PD is unclear, based on our clinical experience and the clinical importance of the complications in patients undergoing PD, we hypothesized that lower limb ulcer is associated with peritonitis in patients on PD.
Patients and Methods: In this single center, retrospective cohort study, we studied 87 patients who started undergoing PD at our hospital from April 2015 to March 2020. We compared these 8 patients with lower limb ulcer with the other 79 patients without lower limb ulcer. We compared between the patients in the objection period of this study about peritonitis using Log rank test, and used the unpaired t-test and Fisher’s exact test to compare the clinical factors between the two groups. Moreover, we used univariate and multivariate logistic regression analyses to study the association of PD-related peritonitis with the clinical factors.
Results: The period developed first peritonitis of the patients on PD with lower limb ulcer was significant shorter than those without lower limb ulcer in Log rank test (P = 0.011). The Fisher’s exact test and unpaired t-test showed that the difference in the prevalence of PD-related peritonitis (P = 0.009), peritonitis/patient years (P = 0.036), the BMI (P = 0.007) and icodextrin (P = 0.001) were significant. Lower limb ulcer had significant associations with peritonitis in patients on PD in both univariate [odds ratio (OR) 8.461, 95% confidence interval (CI) 1.854– 45.60, P = 0.006] and multivariate [OR 7.169, 95% CI 1.519– 39.480, P = 0.013] logistic regression analysis.
Conclusion: In conclusion, lower limb ulcer may be associated with peritonitis in patients undergoing PD. Further large-scale, prospective studies are required to confirm these results.

Keywords: peritoneal dialysis, peritonitis, lower limb ulcer

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