It has been known that the P1 and Lewis antigens on red blood cells (RBCs) affect the risk of Escherichia coli–related urinary tract infection. In the present study, we investigated the associations between those antigens and peritoneal dialysis (PD)–related peritonitis and E. coli peritonitis.
We recruited 155 patients (66 men, 89 women) who were under PD treatment in July 2005, checked the P1 and Lewis antigen status of their RBCs, reviewed their medical charts, and recorded the dates and the causative pathogens of peritonitis episodes. The relationships between peritonitis and the antigens were analyzed.
The mean age of these PD patients was 52.5 ± 14.9 years, and the mean PD duration was 39.8 ± 38.2 months. A total of 66 peritonitis episodes occurred (over 93.4 patient– months) in 41 patients, with 8 patients having more than 1 episode. In particular, E. coli peritonitis accounted for 16 of the 66 peritonitis episodes. We fitted two multiple Cox proportional hazards models (with the robust variance method) for predicting the hazard rates of peritonitis-free and E. coli peritonitis-free survival times to our right-censored data with recurrent events. We found that patients on PD treatment for less than 4 years with (A) lower serum albumin, (B) one or more previous peritonitis episodes, or (C) negative Lewis a and positive Lewis b antigens (secretor) would be at higher risk of peritonitis. And, conditioning on blood type, the PD patients with one or more previous peritonitis episodes and (A) positive P1 antigen, (B) negative Lewis a and positive Lewis b antigens (secretor), or (C) positive Lewis a and negative Lewis b antigens (non-secretor) would be at higher risk of E. coli peritonitis.
National Kidney Foundation.K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis2002; 39(Suppl 1):S1–266.
2.
LeveyASAtkinsRCoreshJCohenEPCollinsAJEckardtKU. Chronic kidney disease as a global public health problem: approaches and initiatives—a position statement from Kidney Disease Improving Global Outcomes. Kidney Int2007; 72:247–59.
3.
KawaguchiYHasegawaTKuboHYamamotoHNakayamaMShigematsuT.Current issues of continuous ambulatory peritoneal dialysis. Artif Organs1995; 19:1204–9.
4.
FriedLFBernardiniJJohnstonJRPirainoB.Peritonitis influences mortality in peritoneal dialysis patients. J Am Soc Nephrol1996; 7:2176–82.
5.
PirainoBBernardiniJSorkinM.Catheter infections as a factor in the transfer of continuous ambulatory peritoneal dialysis patients to hemodialysis. Am J Kidney Dis1989; 13:365–9.
6.
GolperTABrierMEBunkeMSchreiberMJBartlettDKHamiltonRW. Risk factors for peritonitis in long-term peritoneal dialysis: Network 9 peritonitis and catheter studies. Am J Kidney Dis1996; 28:428–36.
7.
HuangJWHungKYYenCJWuKDTsaiTJ. Systemic lupus erythematosus and peritoneal dialysis: outcomes and infectious complications. Perit Dial Int2001; 21:143–7.
8.
SpiegelDMAndersonMCampbellUHallKKellyGMcClureE. Serum albumin: a marker for morbidity in peritoneal dialysis patients. Am J Kidney Dis1993; 21:26–30.
9.
BenderFHBernardiniJPirainoB.Prevention of infectious complications in peritoneal dialysis: best demonstrated practices. Kidney Int Suppl2006; (103):S44–54.
10.
SzetoCCChowVCChowKMLaiRWChungKYLeungCB. Enterobacteriaceae peritonitis complicating peritoneal dialysis: a review of 210 consecutive cases. Kidney Int2006; 69:1245–52.
BlackwellCC. The role of ABO blood groups and secretor status in host defenses. FEMS Microbiol Immunol1989; 1:341–9.
13.
SheinfeldJSchaefferAJCordon–CardoCRogatkoAFairWR. Association of the Lewis blood-group phenotype with recurrent urinary tract infection in woman. N Engl J Med1989; 320:773–7.
14.
ZieglerTJacobsohnNFunfstuckR.Correlation between blood group phenotype and virulence properties of Escherichia coli in patients with chronic urinary tract infection. Int J Antimicrob Agents2004; 24(Suppl 1):S70–5.
15.
ChildsSJEganRJ. Microbiology and epidemiology in recurrent lower urinary tract infections. Infect Urol1998; 11:88–92.
16.
GokalR.Peritoneal dialysis in the 21st century: an analysis of current problems and future developments. J Am Soc Nephrol2002; 13(Suppl 1):S104–16.
17.
PirainoBBailieGRBernardiniJBoeschotenEGuptaAHolmesC. ISPD Ad Hoc Advisory Committee: peritoneal dialysis–related infections recommendations: 2005 update. Perit Dial Int2005; 25:107–31.
18.
PirainoBBernardiniJHolleyJLPerlmutterJA. A comparison of peritoneal dialysis–related infections in short- and long-term peritoneal dialysis patients. Perit Dial Int1993; 13:194–7.
19.
ChowKMLiPK. Peritoneal dialysis-related peritonitis: can we predict it?Int J Artif Organs2007; 30:771–7.
20.
ChowKMSzetoCCLeungCBKwanBCLawMCLiPK. A risk analysis of continuous ambulatory peritoneal dialysis-related peritonitis. Perit Dial Int2005; 25:374–9.
21.
JoshiNCaputoGMWeitekampMRKarchmerAW. Infections in patients with diabetes mellitus. N Engl J Med1999; 341:1906–12.
22.
YuLCChuCCChanYSChangCYTwuYCLeeHL. Polymorphism and distribution of the secretor α(1,2)-fucosyltransferase gene in various Taiwanese populations. Transfusion2001; 41:1279–84.
