RACE AND THE RISK OF PERITONITIS - AN ANALYSIS OF FACTORS ASSOCIATED WITH THE INITIAL EPISODE

To study how clinical characteristics influence the risk of peritoniti s in African American patients with end-stage renal disease treated wi th continuous ambulatory peritoneal dialysis (CAPD), we examined the r isk of developing a first episode of peritonitis among 1,595 new dialy sis patients initially treated by CAPD over a two year period in North Carolina, South Carolina, and Georgia (Network 6). Characteristics ex amined were demographic and socioeconomic factors, functional status, serum albumin and comorbid conditions. There were 538 initial episodes of peritonitis during an average of 8.8 patient months of follow-up; the time to peritonitis for the entire cohort was 26 months. Factors f ound to be independently associated with a risk for peritonitis were s tudent status (Odds Ratio and 95% Confidence Interval = 2.4; 1.4 to 4. 3), rental housing (1.2; 1.0 to 1.5), and substance abuse (1.9; 1.1 to 3.2). African Americans were 60% more likely to have an initial episo de of peritonitis during follow-up than whites (1.6; 1.3 to 1.8). The time to the initial episode was 21 months for African Americans versus 32 months for whites (P < 0.001). Even after adjusting for other fact ors, African Americans were significantly more likely to develop perit onitis (1.5; 1.2 to 1.8). Thus, the increased risk of peritonitis of A frican American patients treated by CAPD is independent of other demog raphic, socioeconomic and comorbid characteristics.