Association of hypoalbuminemia with the risk of peritoneal dialysis-associated peritonitis in peritoneal dialysis patients: a meta-analysis.

IF 2.2 3区医学 Q3 HEMATOLOGY Blood Purification Pub Date : 2025-02-10 DOI:10.1159/000543693

Danfeng Zha, Xionghao Yang, Huiqin Xi

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Abstract

Introduction: The purpose of this meta-analysis was to assess the association between hypoalbuminemia and the risk of peritoneal dialysis-associated peritonitis (PDAP) in patients receiving peritoneal dialysis (PD).

Methods: By the specified deadline of November 13, 2023, a systematic search across various databases was conducted to identify relevant literature. The databases searched included PubMed, Embase, the Cochrane Library, Web of Science, the China National Knowledge Infrastructure (CNKI), WanFang, and VIP. The effect sizes were quantified using odds ratios (OR) or hazard ratios (HR) and were presented with 95% confidence intervals (CI). The analysis was stratified by the type of PD [continuous ambulatory peritoneal dialysis (CAPD), mixed] and the timing of albumin (ALB) level measurements (at baseline, after initiation of PD, or average over time).

Results: A total of 14 studies encompassing 6,448 PD patients were incorporated in this meta-analysis. The findings revealed a significantly elevated risk of peritonitis in patients with hypoalbuminemia compared to those with an ALB level above 3.5g/dL (OR: 2.70, 95% CI: 1.78 to 4.09, P <0.001). Stratification by PD modality showed consistent results within the CAPD group (OR: 5.79, 95% CI: 3.57 to 9.41, P <0.001). For the timing of ALB measurements, the baseline measurement group maintained these findings (OR: 2.53, 95% CI: 1.40 to 4.58, P =0.002), while the group with post-PD measurements did not show statistical significance (OR: 0.76, 95% CI: 0.49 to 1.17, P =0.212). The HR analysis similarly indicated an increased risk of peritonitis in hypoalbuminemia patients compared to those with higher serum ALB levels (HR: 1.62, 95% CI: 1.44 to 1.82, P <0.001).

Conclusion: Our meta-analysis reveals that hypoalbuminemia raises the risk of peritonitis in PD patients, particularly at baseline. This finding underscores the need for close monitoring to detect peritonitis early. Further research is needed to understand the impact of ALB levels post-PD initiation on peritonitis risk.

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.