Whether The Diabetes And Smoking Are The Risk Factors Of Peritoneal Dialysis-Related Peritonitis:A Meta-Analysis

Background and Objective:Peritoneal dialysis(PD) is an available treatment for end-stage renal disease(ESRD) patients, which has been applied widely all over the world, bringing much advantageous to the ESRD patients. Though the technique of PD has improved increasingly, the peritoneal dialysis-related peritonitis is the common complication to the PD patients, which accounts for the technique failure of PD and the removing of catheter. Some patients have to turn to hemodialysis or die eventually. Therefore, it is most significant that we should recognize, prevent and remedy some risk factors so as to decrease the incidence of PDRP and the mortality of PD patients. Generally speaking, there are modifiable and fixed factors about the risk factors of PDRP. The modifiable factors including malnutrition, overweight, smoking, drug and so on, and the fixed factors including age, sex, race, diabetes and so on. It is universally acknowledged that diabetes is a risk factor for the infection. The incidence of infection will increase for the poorly controlled of glucose. So, we also regard the diabetes as the risk factor to the PD patients. However, there are some arguments about the role of diabetes to the incidence of PDRP. Some studies had testified that diabetes could increase the risk of PDRP, other study, however, did not show the association between the diabetes and PDRP. Smoking is a public health problem for the sake of the harm of poisonous substance of tobacco to the health of people which can impact the immunity through various means. There are some arguments about the role of diabetes to the incidence of PDRP from the current research results. Some studies had testified that smoking could increase the risk of PDRP, other study, however, did not show the association between the smoking and PDRP. Therefore, this study aims to identify the role of diabetes and smoking to the incidence of PDRP through the Meta-analysis basing on the case-control researches which were published online from January 1977 to December 2015.Methods :To search the relative case-control researches which were published online from January 1977 to December 2015. The key words and the searching methods are: peritoneal dialysis-related peritonitis and diabetes mellitus, peritoneal dialysis-related peritonitis and smoking, peritoneal dialysis-related peritonitis and cigarette, peritoneal dialysis-related peritonitis and risk factor, peritoneal dialysis-related infections and diabetes mellitus, peritoneal dialysis-related infections and smoking, peritoneal dialysis-related infections and cigarette, peritoneal dialysis-related infections and risk factor, peritoneal dialysis-related complications and diabetes mellitus, peritoneal dialysis-related complications and smoking, peritoneal dialysis-related complications and cigarette, peritoneal dialysis-related complications and risk factor. Then we screened the studies according to the criterion, and evaluated the quality of studies through NOS. Additionally,we have systematically review the history of the patients who were diagnosed PDRP in our hospital from 2000 to 2015.Next, we applied the Comprehensive Meta-analysis V3.exe software to analyze the data to identify that whether diabetes and smoking are the risk factors for PDRP. Results: We have searched twenty studies about the relation between diabetes and PDRP, Four studies about the relation between smoking and PDRP respectively. Some studies did not provide the number of the case and control group instead of OR and 95% confidence. This had little influence on the outcome of the study. The outcomes of Meta-analysis demonstrated that diabetes is the risk factors for PDRP( OR=2.105, 95%CI=1.580-2.803,P<0.01) and the smoking is the risk factors for PDRP too( OR=1.264, 95%CI=1.552-2.229,P<0.05).Conclusion : Diabetes and smoking are the risk factors for PDRP.