Modelling recurrent episodes of peritonitis among patients who are in peritoneal dialysis at Pietersburg Provincial Hospital, Limpopo Province, South Africa

Abstract

Recurrent peritonitis is a major problem of peritoneal dialysis (PD) due to its association with technique failure in the dialysis process. The literature on peritonitis focused only on investigating major risk factors associated with the first episode of peritonitis. However, this dissertation investigates factors associated to multiple episodes of peritonitis, to a maximum of 6 episodes. The correlation of recurrent episodes of a patient is considered. The univariate counting process, stratified, gap-time and marginal hazard regression models are applied to select the significant covariates to the multivariate regression hazard models. Regression coefficient for covariates are found to be statistically significant at 5% level. The application of Akaike information criterion (AIC) and Schwarz bayesian criterion (SBC) assisted to filter out the best method which is the stratified regression hazard model. The major risk factors associated with recurrent episodes of peritonitis are examined from the selected good fitting model. In conclusion, the selected model identified two independent risk factors to be significantly associated with recurrent episodes of peritonitis: marital status and glomerularfiltrationrate. Twocategoriesofmaritalstatus, divorceandwidowerare the significant factors compared to married patients (when taking married patients as the reference category).