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Serum immunoglobulin G levels and peritonitis in peritoneal dialysis patients

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Abstract

Background

Peritonitis is a frequent and serious complication of peritoneal dialysis (PD). Whether low immunoglobulin level is associated with PD-related peritonitis is unknown.

Methods

We conducted a prospective study to assess whether immunoglobulin levels at PD onset could predict the occurrence of peritonitis. All patients starting peritoneal dialysis between 01/2005 and 12/2010 at the University hospital of Besançon, France, were included in the study.

Results

Of 240 consecutive PD patients enrolled (mean follow-up 25 ± 12 months), 76 (32 %) had at least one episode of peritonitis. Mean immunoglobulin (Ig)G level at PD start was lower in patients who subsequently experienced peritonitis (7.9 + 3.4 vs. 9.7 + 3.4 g/l, p = 0.005). An increased IgG level at PD onset was associated with a reduced risk of peritonitis [hazard ratio (HR) 0.88, 95 % confidence interval (CI) 0.80–0.97 for each increase of 1 g/l in IgG, p = 0.008]. IgG level ≤6.4 g/l (“low IgG”) was the best predictive value for the occurrence of subsequent peritonitis: 52 patients (24 %) had low IgG levels. At multivariate analysis, both low IgG level (HR 2.49, 95 % CI 1.32–4.69, p = 0.005) and diabetes (HR 2.78, 95 % CI 1.49–5.20, p = 0.001) were predictive of the occurrence of peritonitis.

Conclusion

Low IgG levels predict the occurrence of PD-related peritonitis. Randomized studies should determine whether such patients could benefit from intravenous immunoglobulin administration.

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Conflict of interest

The authors have no conflict of interest as defined by Journal of Nephrology.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. INSERM UMR1098, Fédération Hospitalo-Universitaire INCREASE, 25020, Besançon, France

    Cécile Courivaud, Thomas Crepin & Didier Ducloux

  2. Université de Franche-Comté, IFR133, 25020, Besançon, France

    Cécile Courivaud, Thomas Crepin & Didier Ducloux

  3. Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, 25030, Besançon, France

    Cécile Courivaud, Thomas Crepin, Catherine Bresson-Vautrin & Didier Ducloux

  4. Department of Biochemistry, CHU Besançon, 25030, Besançon, France

    Karine Bardonnet

  5. CHU Besançon, CIC-BT 506, 25030, Besançon, France

    Didier Ducloux

  6. Department of Nephrology, Dialysis, and Renal Transplantation, CHU Dijon, 21000, Dijon, France

    Jean-Michel Rebibou

Authors
  1. Cécile Courivaud
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  2. Karine Bardonnet
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  3. Thomas Crepin
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  4. Catherine Bresson-Vautrin
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  5. Jean-Michel Rebibou
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  6. Didier Ducloux
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Corresponding author

Correspondence to Didier Ducloux.

Additional information

The results presented in this paper have not been published previously as a whole or in part.

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Courivaud, C., Bardonnet, K., Crepin, T. et al. Serum immunoglobulin G levels and peritonitis in peritoneal dialysis patients. J Nephrol 28, 511–515 (2015). https://doi.org/10.1007/s40620-015-0176-2

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  • DOI: https://doi.org/10.1007/s40620-015-0176-2

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