What are the risk factors for peritonitis in SLE patients undergoing dialysis?

For patients with systemic lupus erythematosus (SLE) who are undergoing peritoneal dialysis, the risk of peritonitis development may increase with the use of gastric acid suppressants and glucocorticoids and in males, according to a retrospective study.

Researchers performed propensity score matching to establish a paired cohort of 46 patients with SLE and 46 individuals with no SLE (control). Matching was based on sex, date of peritoneal dialysis initiation, diabetes mellitus, and age at peritoneal dialysis initiation.

The incidence of peritonitis and its risk factors were evaluated using Poisson regression and time-dependent Cox proportional hazards regression analyses.

Peritonitis occurred more frequently among SLE patients than controls, at an incidence rate of 0.32 vs 0.25 episodes per patient-year (risk ratio, 1.30; p=0.15). There were no significant between-group differences in time to first peritonitis episode, peritonitis-associated catheter removal, and mortality rates.

Several factors showed a positive, independent association with peritonitis in the SLE group. These included male sex (hazard ratio [HR], 2.29, 95 percent confidence interval [CI], 1.22–4.27; p=0.009), gastric acid suppressants (HR, 8.71, 95 percent CI, 2.53–30.05; p<0.001), and glucocorticoid use (HR, 1.16, 95 percent CI, 1.08–1.26; p<0.001).

Notably, there was a significant number of peritonitis cases observed among SLE patients not receiving glucocorticoid.