Higher risk of infection and death in First Nations people on peritoneal dialysis

Jul 26, 2010

First Nations people in Canada on peritoneal dialysis are at increased risk of peritonitis and death, irrespective of whether they live in a rural or urban location, found a study published in CMAJ.

The high prevalence of diabetes, obesity and hypertension in Canada's First Nations, or aboriginal, population is fuelling the rapid growth of and and consequent need for care and dialysis.

Peritonitis is inflammation of the peritoneum (the inner lining of the abdominal and pelvic walls), often caused by infection.

Peritoneal dialysis (PD) uses the peritoneum through which to filter wastes and excess water compared with hemodialysis which filters these externally through a filter. requires living close to a dialysis centre whereas peritoneal dialysis can be conducted by patients at home. In Canada, approximately 18% of dialysis patients are on peritoneal dialysis.

The study, by researchers from St. Boniface General Hospital and the University of Manitoba in Winnipeg, Manitoba, looked at 727 adults with end stage on peritoneal dialysis from 1997 to 2007 in Manitoba. Of this total, 161 were First Nations and 566 non-First Nations.

"In this large cohort of peritoneal dialysis patients, First Nations status was associated with an increase in mortality and peritonitis after adjusting for baseline demographics, co-morbidities and peritoneal characteristics, and these findings were independent of residing in an urban or rural environment," writes Dr. Manish Sood with coauthors.

The authors suggest that the increase in mortality may be due to dialysis clearance, with underlying inflammation and failure to clear fluid, although they stress this needs to be investigated.

They note that while geographic isolation and distance from health care can be associated with increased risk of death in people on dialysis, there was no difference between urban and rural First Nations patients on peritoneal dialysis.

"As many First Nations people live in the remote north, it was reassuring that patients far from their health care providers did no worse then those closer," write the authors. "Many patients, after experiencing kidney failure and initiating dialysis, relocate to cities which isolates them from family, culture and community. Our findings suggest there is no need to relocate patients."

More research into improving outcomes for First Nations dialysis patients is needed.

Explore further: West Africa's Ebola outbreak has claimed 137 lives

More information: www.cmaj.ca/cgi/doi/10.1503/cmaj.100105

add to favorites email to friend print save as pdf

Related Stories

New peritoneal dialysis diagnostic discovered

Oct 17, 2007

Thanks to a discovery by scientists at Robarts Research Institute and The University of Western Ontario, patients undergoing peritoneal dialysis may soon be able to worry less about the risks of infection and lessen their ...

The cost of improving dialysis care

Nov 02, 2009

Improving survival among dialysis patients may increase treatment costs significantly, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, ...

Popular heart drug may be unsafe for some kidney patients

Jun 24, 2010

For patients with kidney disease on dialysis, the widely used heart medication digoxin may lead to an increased risk of premature death, according to a study appearing in an upcoming issue of the Journal of the American So ...

Recommended for you

Researchers discover target for treating dengue fever

13 hours ago

Two recent papers by a University of Colorado School of Medicine researcher and colleagues may help scientists develop treatments or vaccines for Dengue fever, West Nile virus, Yellow fever, Japanese encephalitis and other ...

Tracking flu levels with Wikipedia

13 hours ago

Can monitoring Wikipedia hits show how many people have the flu? Researchers at Boston Children's Hospital, USA, have developed a method of estimating levels of influenza-like illness in the American population by analysing ...

User comments : 0

More news stories

Leeches help save woman's ear after pit bull mauling

(HealthDay)—A pit bull attack in July 2013 left a 19-year-old woman with her left ear ripped from her head, leaving an open wound. After preserving the ear, the surgical team started with a reconnection ...

Scientists tether lionfish to Cayman reefs

Research done by U.S. scientists in the Cayman Islands suggests that native predators can be trained to gobble up invasive lionfish that colonize regional reefs and voraciously prey on juvenile marine creatures.

Venture investments jump to $9.5B in 1Q

Funding for U.S. startup companies soared 57 percent in the first quarter to a level not seen since 2001, as venture capitalists piled more money into an increasing number of deals, according to a report due out Friday.