Impact of environmental particulate matter and peritoneal dialysis-related infection in patients undergoing peritoneal dialysis

In patients undergoing peritoneal dialysis (PD), PD-related infection is a major cause of PD failure and hospital admission. Good air quality is required when dialysate exchange or exit site wound care is performed. To our knowledge, investigation of air pollution as a factor for PD-related infection in patients undergoing dialysis is limited. This study aimed to assess the effect of environmental particulate matter (PM) and other important risk factors on 1-year PD-related infection in patients undergoing PD.

A total of 175 patients undergoing PD were recruited in this 1-year retrospective observational study. Differences in environmental PMs (PM₁₀ and PM_2.5) were analyzed with respect to the patients' living areas. The patients undergoing PD were categorized into 2 groups according to PM_2.5 exposure: high (n=61) and low (n=114). Demographic, hematological, nutritional, inflammatory, biochemical, and dialysisrelated data were analyzed. Multivariate binary logistic and multivariate Cox regression analyseswere used to analyze 1-yearPD-related infection.

A total of 175 patients undergoing PD (50men and 125 women) were enrolled. Thirty-five patients had PD-related infection within 1 year. Multivariate Cox regression analysis showed that high environmental PM_2.5 exposure (hazard ratio (HR): 2.0, 95% confidence interval [CI] [1.03-3.91]; P=.04) and female sex (HR: 2.77, 95% CI [1.07-7.19]; P=.03) were risk factors for 1-year PD-related infection.

Patients undergoing PD with high environmental PM_2.5 exposure had a higher 1-year PD-related infection rate than that in those with low exposure. Therefore, air pollution may be associated with PD-related infection in such patients.