{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:09:56Z","timestamp":1784182196866,"version":"3.55.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peritoneal dialysis\u2013associated peritonitis (PDAP) remains a major complication of peritoneal dialysis (PD) and is a leading cause of hospitalization, technique failure, and mortality. Hypertension is highly prevalent among PD patients; however, its association with PDAP risk has not been well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study including adult PD patients followed between January 1, 2007, and December 31, 2024. Clinical characteristics, laboratory parameters, dialysis-related features, and PDAP events were systematically collected. Hypertension was defined by a documented diagnosis, long-term use of antihypertensive medications, or repeated blood pressure measurements \u2265140\/90 mmHg at baseline. The cumulative incidence of PDAP was assessed using cumulative incidence function (CIF) curves and Gray\u2019s test. Independent associations were evaluated using Fine\u2013Gray competing risk models and multivariable logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 352 PD patients, 194 (55.1%) had hypertension. During a mean follow-up of 46.1 months, hypertensive patients exhibited a significantly higher cumulative incidence of PDAP. After multivariable adjustment, hypertension remained independently associated with a higher risk of PDAP in both Fine\u2013Gray competing risk models (HR\u00a0=\u00a04.46, 95% CI 2.49\u20137.99,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) and logistic regression analyses (OR\u00a0=\u00a04.38, 95% CI 2.11\u20139.08,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). In descriptive microbiological analyses, hypertensive patients showed a higher proportion of gram-negative organisms, whereas gram-positive organisms predominated in non-hypertensive patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Baseline hypertension was independently associated with a higher risk of PDAP in patients undergoing PD. These findings highlight the potential importance of blood pressure status in PDAP risk stratification and long-term PD management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1807316","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:37:50Z","timestamp":1784180270000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypertension is associated with an increased risk of peritoneal dialysis\u2013associated peritonitis: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Shiyuan","family":"Zhong","sequence":"first","affiliation":[{"name":"Zhongshan Hospital of Traditional Chinese Medicine","place":["Zhongshan, China"]},{"name":"The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine","place":["Zhongshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiying","family":"Liu","sequence":"additional","affiliation":[{"name":"Zhongshan Hospital of Traditional Chinese Medicine","place":["Zhongshan, China"]},{"name":"The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine","place":["Zhongshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhongshan Hospital of Traditional Chinese Medicine","place":["Zhongshan, China"]},{"name":"The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine","place":["Zhongshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiefen","family":"Hu","sequence":"additional","affiliation":[{"name":"Zhongshan Hospital of Traditional Chinese Medicine","place":["Zhongshan, China"]},{"name":"The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine","place":["Zhongshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju","family":"Huang","sequence":"additional","affiliation":[{"name":"Zhongshan Hospital of Traditional Chinese Medicine","place":["Zhongshan, China"]},{"name":"The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine","place":["Zhongshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanlin","family":"Li","sequence":"additional","affiliation":[{"name":"Zhongshan Hospital of Traditional Chinese Medicine","place":["Zhongshan, China"]},{"name":"The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine","place":["Zhongshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Zhongshan Hospital of Traditional Chinese Medicine","place":["Zhongshan, China"]},{"name":"The Tenth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine","place":["Zhongshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1053\/j.ajkd.2021.03.022","article-title":"Variation in peritoneal dialysis-related peritonitis outcomes in the peritoneal dialysis outcomes and practice patterns study (PDOPPS)","volume":"79","author":"Al Sahlawi","year":"2022","journal-title":"Am. J. Kidney Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1177\/03913988231206641","article-title":"Effect of low-calcium and standard-calcium dialysate on serum calcium, phosphorus and full-segment parathyroid hormone in patients on peritoneal dialysis: a retrospective observational study","volume":"46","author":"An","year":"2023","journal-title":"Int. J. Artif. Organs."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11092362","article-title":"Calcium, phosphorus and magnesium abnormalities associated with COVID-19 infection, and beyond","volume":"11","author":"Anghel","year":"2023","journal-title":"Biomedicines"},{"key":"B4","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s10479-024-06026-0","article-title":"Towards sustainable dialysis modality selection: a multi-expert fuzzy analytical hierarchy process based approach for guided decision making","volume":"351","author":"Chabouh","year":"2024","journal-title":"Ann. Oper. Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1001\/jama.2024.16338","article-title":"Dialysis for chronic kidney failure: a review","volume":"332","author":"Flythe","year":"2024","journal-title":"JAMA"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.9425","article-title":"Intestinal ischemia: a rare and less common complication after laparoscopic cholecystectomy-a case report and literature review","volume":"12","author":"Ghamari","year":"2024","journal-title":"Clin. Case Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1016\/j.fertnstert.2022.03.009","article-title":"Polycystic ovary syndrome: a \"risk-enhancing\" factor for cardiovascular disease","volume":"117","author":"Guan","year":"2022","journal-title":"Fertil. Steril."},{"key":"B8","doi-asserted-by":"publisher","first-page":"5515","DOI":"10.1182\/blood-2024-199491","article-title":"Hypertension-mediated gut microbiota changed exacerbate oxidative phosphorylation and fatty acid metabolism in the colon","volume":"144","author":"Guo","year":"2024","journal-title":"Blood"},{"key":"B9","doi-asserted-by":"publisher","first-page":"25","DOI":"10.3747\/pdi.2017.00207","article-title":"Survival and kidney transplant incidence on home versus in-center hemodialysis, following peritoneal dialysis technique failure","volume":"39","author":"Kansal","year":"2019","journal-title":"Perit. Dial. Int."},{"key":"B10","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1159\/000542427","article-title":"Impact of peritoneal neutrophil extracellular traps on peritoneal characteristics and technical failure in patients undergoing peritoneal dialysis","volume":"56","author":"Kim","year":"2025","journal-title":"Am. J. Nephrol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"623","DOI":"10.3747\/pdi.2015.00218","article-title":"Duration of hemodialysis following peritoneal dialysis cessation in Australia and New Zealand: proposal for a standardized definition of technique failure","volume":"36","author":"Lan","year":"2016","journal-title":"Perit. Dial. Int."},{"key":"B12","doi-asserted-by":"publisher","first-page":"16394","DOI":"10.1038\/s41598-022-20757-9","article-title":"Lipidic profiles of patients starting peritoneal dialysis suggest an increased cardiovascular risk beyond classical dyslipidemia biomarkers","volume":"12","author":"Lluesa","year":"2022","journal-title":"Sci. Rep."},{"key":"B13","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1038\/s41581-024-00838-w","article-title":"Immune mechanisms in the pathophysiology of hypertension","volume":"20","author":"Nguyen","year":"2024","journal-title":"Nat. Rev. Nephrol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1038\/s41440-020-0398-0","article-title":"Physician and patient perspectives on hypertension management and factors associated with lifestyle modifications in Japan: results from an online survey","volume":"43","author":"Nishigaki","year":"2020","journal-title":"Hypertens. Res."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1007\/s40620-020-00716-1","article-title":"Changes in serum albumin concentrations during transition to dialysis and subsequent risk of peritonitis after peritoneal dialysis initiation: a retrospective cohort study","volume":"33","author":"Noppakun","year":"2020","journal-title":"J. Nephrol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.cophys.2020.09.016","article-title":"The role of inflammation in hypertension: novel concepts","volume":"19","author":"Patrick","year":"2021","journal-title":"Curr. Opin. Physiol."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.799110","article-title":"Microbiology and outcome of peritoneal dialysis-related peritonitis in elderly patients: a retrospective study in China","volume":"9","author":"Song","year":"2022","journal-title":"Front. Med. (Lausanne)."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12102377","article-title":"Dyslipidemia in peritoneal dialysis: implications for peritoneal membrane function and patient outcomes","volume":"12","author":"Stepanova","year":"2024","journal-title":"Biomedicines"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.2215\/CJN.14631218","article-title":"Peritoneal dialysis-associated peritonitis","volume":"14","author":"Szeto","year":"2019","journal-title":"Clin. J. Am. Soc Nephrol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1097\/HJH.0000000000002453","article-title":"2020 International Society of Hypertension global hypertension practice guidelines","volume":"38","author":"Unger","year":"2020","journal-title":"J. Hypertens."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1007\/s11517-021-02363-5","article-title":"Synchronized research on endothelial dysfunction and microcirculation structure in dorsal skin of rats with type 2 diabetes mellitus","volume":"59","author":"Wei","year":"2021","journal-title":"Med. Biol. Eng. Comput."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2539","DOI":"10.1093\/ckj\/sfab130","article-title":"Treatment practices and outcomes in incident peritoneal dialysis patients: the Swedish Renal Registry 2006-2015","volume":"14","author":"Xu","year":"2021","journal-title":"Clin. Kidney J."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v15.i4.103092","article-title":"Nutritional status of elderly hypertensive patients and its relation to the occurrence of cognitive impairment","volume":"15","author":"Xu","year":"2025","journal-title":"World J. Psychiatry"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1080\/10641963.2023.2195135","article-title":"Gut microbiota and hypertension: association, mechanisms and treatment","volume":"45","author":"Yang","year":"2023","journal-title":"Clin. Exp. Hypertens."},{"key":"B25","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1186\/s12879-024-09334-9","article-title":"Pathogenic spectrum and risk factors of peritoneal dialysis-associated peritonitis: a single-center retrospective study","volume":"24","author":"You","year":"2024","journal-title":"BMC Infect. Dis."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000543693","article-title":"Association of hypoalbuminemia with the risk of peritoneal dialysis-associated peritonitis in peritoneal dialysis patients: a meta-analysis","author":"Zha","year":"2025","journal-title":"Blood Purif."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1654246","article-title":"Epidemiology, drug resistance, and clinical risk factors of peritoneal dialysis-associated peritonitis: a five-year multicenter study","volume":"15","author":"Zhang","year":"2025","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3389\/ebm.2024.10112","article-title":"Calcium-sensing receptor-mediated macrophage polarization improves myocardial remodeling in spontaneously hypertensive rats","volume":"249","author":"Zhao","year":"2024","journal-title":"Exp. Biol. Med. (Maywood)."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1807316\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:37:51Z","timestamp":1784180271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1807316\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":28,"alternative-id":["10.3389\/fcimb.2026.1807316"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1807316","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"article-number":"1807316"}}