Comparison of clinical characteristics of peritoneal dialysis-associated peritonitis in patients with and without di-abetes mellitus
LIN Pei-hong
XIE Wei-ji
HUANG Guo-hai
WANG Yu-kai
Abstract：Objective To compare the clinical manifestations,laboratory findings,microbiological features,and outcomes of peritoneal dialysis-associated peritonitis(PDAP)between diabetic(DM)and non-diabetic(NDM)pa-tients undergoing peritoneal dialysis(PD).Methods Patients receiving maintenance PD who developed PDAP at the Department of Nephrology,Shantou Central Hospital,between January 2018 and December 2022 were retrospectively ana-lyzed.According to the presence or absence of diabetes mellitus,patients were divided into DM and NDM groups.Demo-graphic data,clinical vital signs at admission,laboratory parameters(hematology,biochemistry,inflammatory markers,electrolytes,and dialysate cytology),dialysate culture results,incidence of refractory peritonitis,and clinical outcomes were collected and compared between the two groups.Results A total of 155 PDAP patients were included,comprising 53 in the DM group and 102 in the NDM group.The DM group was significantly older than the NDM group(62.5±8.4 years vs.56.1±12.5 years,P=0.002),with a higher trend in systolic blood pressure(145.3±23.3 mmHg vs.136.6±29.8 mmHg,P=0.065).Compared with the NDM group,DM patients showed lower serum albumin(26.1±5.1 g/L vs.29.5±5.3 g/L,P＜0.001)and creatinine(752.9±253.8 μmol/L vs.883.4±284.0 μmol/L,P=0.007),but higher blood glucose(13.3±7.5 mmol/L vs.6.9±2.1 mmol/L,P＜0.001),triglycerides(1.7±0.9 mmol/L vs.1.4±1.1 mmol/L,P=0.002),and C-reactive protein levels(median 91.5 mg/L vs.52.9 mg/L,P=0.029),with lower serum sodium(133.4±3.9 mmol/L vs.135.3±3.9 mmol/L,P=0.007)and total cholesterol(median 3.6 mmol/L vs.4.3 mmol/L,P=0.017).There were no significant differences between the groups in peritonitis outcome(P=0.226)or incidence of refractory peritonitis(P=0.748).Simplified classification of dialysate culture results indicated a higher proportion of"other/mixed/unclassified"pathogens and a lower proportion of"negative/no growth"cases in the DM group,though the overall difference was not statistically significant(P=0.083).Conclusion In PDAP,concomi-tant diabetes mellitus is an independent factor associated with specific clinical and biochemical abnormalities.After adjust-ment for age and dialysis duration,DM patients still exhibited more pronounced malnutrition(hypoalbuminemia)and met-abolic disturbances(hypertriglyceridemia,hyponatremia).However,their more severe inflammatory response(elevated CRP)and lower serum creatinine may be largely attributable to confounding factors such as age rather than diabetes per se.Comprehensive management of PDAP patients with diabetes should emphasize nutritional support and correction of met-abolic abnormalities.
Keywords：diabetes mellitusperitoneal dialysisperitoneal dialysis-associated peritonitisclinical character-istics
Publication Date：2025-11-15
Online Publishing Date：2026-01-06(First online date of this platform, not the publication date of the document)
Pages：6( 1639-1644 )