Kidney Week

Abstract: FR-PO448

Examining the Relationship between Hygiene Practices and Clinical Outcomes in Patients on Peritoneal Dialysis: Insights from the Thailand PDOPPS Initiative

Session Information

• Home Dialysis - 1
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Klinphayom, Phatcharida, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Bangkok, Thailand

Phatcharida Klinphayom, MD

• Phannajit, Jeerath, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Bangkok, Thailand

Jeerath Phannajit, MD

• Rojsanga, Piyarat, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Bangkok, Thailand

Piyarat Rojsanga, MD

• Eiam-Ong, Somchai, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Bangkok, Thailand

Somchai Eiam-Ong, MD

• Tungsanga, Kriang, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Bangkok, Thailand

Kriang Tungsanga, MD

• Perl, Jeffrey, St Michael's Hospital, Toronto, Ontario, Canada

Jeffrey Perl, MD

• Johnson, David W., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia

David W. Johnson, DrMed, MBBS, PhD, FASN

• Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Roberto Pecoits-Filho, MD, PhD, FASN

• Kanjanabuch, Talerngsak, King Chulalongkorn Memorial Hospital Department of Internal Medicine, Bangkok, Bangkok, Thailand

Talerngsak Kanjanabuch, MD

Background

Peritonitis is a leading cause of hemodialysis (HD) transfer and mortality. We investigated the association between hygiene behavior and clinical outcomes in patients on PD.

Methods

Personal hygiene was assessed in patients across 22 facilities in Thailand Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) during 2016-2021. Hygiene behavior was assessed using a short-form hygiene behavioral questionnaire comprising 8 domains (physical hygiene, prevention of contamination, and PD procedure/protocol) with a yes/no answer format. Poor hygiene behavior was defined as a cumulative score of ≥3. Cox proportional hazards model regression and Poisson regression incidence rate ratio (IRR) were employed to estimate associations between hygiene behavior and clinical outcomes, including mortality, HD transfer, and peritonitis.

Results

Of 1566 randomly selected patients on PD from 22 facilities, 669 consented and reported their hygiene behavior. Poor hygiene behavior was prevalent in the PD population (6%), especially in patients with diabetes and caregiver dependence. Poorer self-reported hygiene behavior at baseline was significantly associated with a higher rate of peritonitis and a shorter time to HD transfer but not death. This association persisted after adjusting for age, gender, PD vintage, comorbidities, shared frailty by study sites, and serum albumin.

Conclusion

Personal hygiene behavior was independently associated with higher risk of peritonitis and shorter time to HD transfer, but not death. The findings could potentially pave the way for evaluating hygiene standards using this tool, which could aid in identifying patients at a heightened risk (risk stratification) and determining those who would benefit from preventive measures.