The impact of shortening patient-doctor contact duration on early peritoneal dialysis-related infections

Sci Rep. 2024 Oct 3;14(1):22955. doi: 10.1038/s41598-024-74205-x.

Abstract

Early peritoneal dialysis (PD)-related infection is a severe complication. This study investigated the relationship between patient-doctor contact (PDC) duration and early PD-related infection. In the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) Korea, incident dialysis patients receiving PD were divided into two groups based on PDC duration (< 15 min versus ≥ 15 min), which was defined as the duration a nephrologist typically spends with a patient receiving PD during each visit according to the facility practice pattern. Early risks of PD-related infections, such as peritonitis and catheter-related infection (onset within 3 and 12 months of PD), were compared to the PDC duration using Cox regression. The study included 276 patients (184 [66.7%] in the shorter PDC group [< 15 min] and 92 [33.3%] in the longer PDC group [≥ 15 min]). The average age did not differ between the groups. The incidences of 3- and 12-month PD-related infections were significantly lower in the longer PDC group than in the shorter PDC group (3 months: 1.1% versus 9.8%, P = 0.007; 12 months: 9.8% versus 23.4%, P = 0.007). Longer PDC was independently associated with a lower risk of PD-related infections at 3 and 12 months (3 months: adjusted hazard ratio [aHR], 0.11; 95% confidence interval [CI], 0.02-0.85, P = 0.034; 12 months: aHR, 0.43; 95% CI 0.19-0.99, P = 0.048). Overall, a longer PDC duration was associated with a significantly lower risk of early PD-related infection.

Keywords: Catheter-related infection; PD-related infection; Patient–doctor contact hour; Peritoneal dialysis; Peritonitis.

MeSH terms

  • Adult
  • Aged
  • Catheter-Related Infections / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Peritoneal Dialysis* / adverse effects
  • Peritonitis / epidemiology
  • Peritonitis / etiology
  • Physician-Patient Relations
  • Proportional Hazards Models
  • Republic of Korea / epidemiology
  • Risk Factors
  • Time Factors