Statistical Analysis - Using the Conditional and Marginal Approaches - of Recurrent Peritonitis Occurrence in End Stage Kidney Failure Patients under Peritoneal Dialysis. Application to a Real Patient Sample

Peritoneal dialysis (PD) is a procedure used to remove waste product, via the abdomen, from the body when the kidneys cannot adequately perform their function. Peritonitis remains a significant complication of peritoneal dialysis, resulting in a leading cause of hospitalization, catheter loss, technique failure, and a common cause of death in PD patients. Type 1 right censored dataset of 250 was used in end-stage kidney failure patients undergoing continuous ambulatory peritoneal dialysis from 1991 to 2010. The study aims to identify potential risk factors that contribute to the reoccurring risk of peritonitis using conditional and marginal approaches. The conditional approach of Andersen and Gill model reports the intensity of peritonitis, where increased age and presence of diabetes seem to decrease the risk of recurrent peritonitis. While under the marginal approach (Marginal Means model), the paper shows a decreased risk of recurrent peritonitis in diabetic patients. Analysing the result of condition and marginal approach alongside Cox model, the decreased risk of recurrent peritonitis could be attributed to an increased risk of death in the patients. In addition, there seems to be no significant difference between gender and the risk of peritonitis in both models. Both models confirm the apparent protective effect of diabetes and absent effect of gender on the recurrent risk of peritonitis.