Ronald Pisoni

Jeffrey Perl

New Project Will Study Peritonitis Infection in Peritoneal Dialysis Patients

A research team led by Arbor Research Collaborative for Health and St. Michael’s Hospital in Toronto was recently awarded a five-year contract from the Agency for Healthcare Research and Quality to study peritonitis infection in peritoneal dialysis (PD) patients. This project will function as an ancillary study of the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).

Home-based PD is used by approximately 10 percent of dialysis patients in the United States and 20 percent in Canada. Patients indicate that peritoneal dialysis provides particular benefits meaningful for their quality of life, while attaining clinical outcomes comparable to hemodialysis (HD). In 2013, 15 percent of PD patients in the United States had at least one reported incident of peritonitis, an inflammation of the tissue lining the inner walls of the abdomen usually caused by an infection. PD-associated peritonitis is a leading cause of PD-related treatment failure requiring transition to in-center HD, and is associated with increased risks of hospitalizations and death.

This project aims to identify high-risk patients and clinical practices associated with peritonitis risk to help further inform best practice guidelines for reducing risk. Working with a broad group of US stakeholders, other key goals of this project are to create a meaningful approach for standardized reporting of peritonitis episodes and to promote knowledge dissemination strategies that foster continuous quality improvement activities and clinical treatment pathways for preventing peritonitis in PD care settings.

Co-Principal Investigator Ronald Pisoni of Arbor Research Collaborative for Health noted, “We are very excited and honored to have the opportunity to carry out this work aimed at decreasing peritonitis rates in the US and more broadly across the world.”

The PDOPPS is the largest multinational prospective cohort study of PD to date, consisting of more than 240 randomly selected PD units and more than 12,000 PD patients in nine countries, including Canada and the US. The large and highly detailed international data collection afforded by the PDOPPS will give investigators a unique opportunity to understand key aspects of PD practices that are associated with decreased occurrence of peritonitis.

“I am thrilled for this important and highly relevant research opportunity. Many patients prefer home-based peritoneal dialysis, so it is important that we identify and address any issues associated with it, and reduce any subsequent risks,” commented Co-Principal Investigator Jeffrey Perl of St. Michael’s Hospital.

Drs. Pisoni and Perl will be joined by a team of co-investigators from the University of Colorado (Dr. Isaac Teitelbaum), DaVita (Dr. Martin Schreiber), the University of Michigan (Dr. Doug Schaubel), the University of Pittsburgh (Dr. Beth Piraino), and the University of Western Australia (Dr. Neil Boudville), as well as stakeholders including patient representatives, dialysis provider organizations, the American Society of Nephrology (ASN) Nephrologists Transforming Dialysis Safety (NTDS) initiative, the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network, the International Society for Peritoneal Dialysis (ISPD), the International Pediatric PD Network (IPPN), and the Standardizing Care to Improve Outcomes in Pediatric End-Stage Renal Disease (SCOPE) pediatric end-stage renal disease collaborative.

About Arbor Research Collaborative for Health
Arbor Research Collaborative for Health is committed to improving patient care through research that shapes medical policies and practice. In particular, Arbor Research conducts health outcomes research on chronic disease and end-stage organ failure, with expertise in biostatistical analysis, clinical practice, health economics, public policy, database management and integration, and project coordination. Through research projects that are national and global in scope, Arbor Research’s scientific collaborations provide valuable and timely information to the worldwide health care community.

About St. Michael's Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About the DOPPS Program
The mission of the DOPPS Program is to improve the experience of patients with kidney disease by identifying links between international variations in clinical practices and outcomes. Started as a hemodialysis study in 1996, the DOPPS Program has tracked over 120,000 patients on hemodialysis (DOPPS), peritoneal dialysis (PDOPPS), and with advanced chronic kidney disease (CKDopps), in over 20 countries. Please visit to learn more about the DOPPS Program.

May 4, 2018
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