Epidemiology and Treatment Outcome of Peritoneal Dialysis (PD)-Related Peritonitis
Abstract
Background : Peritoneal dialysis (PD)-related peritonitis is a common and serious complication of this modality which is ranging from 0.24 to 1.66 episodes per patient-year.
Objectives : This study were to describe demographic characteristics and identify factors contributed to PD-related peritonitis treatment failurefrom the five PD unit in Kalasin province.
Methods : Medical records of peritoneal dialysis patients in 5 centers in Kalasin province during October, 2016 to September, 2017 were reviewed. Patient’s characteristics, laboratory and microorganism data as well as outcome of the treatment were recorded. Factors associated with treatment failure were identified by univariable and multivariable analysis with STATA computer.
Results : The overall peritonitis rate was 0.35 episodes per patient-year. The median age of patients was 56 years (rang 22 to 83 years). The median duration of peritoneal dialysis in this study was 647.5 days (range 12 to 2,918 days). Among 128 episodes of peritonitis, 70 (54.6%) were culture-negative, 29 (22.6%) were infected by Gram-positive organisms and 27 (21.0%), Staphylococcus aureus and Streptococcus group D-not enterococci identified in 9 (16.0%), 5 (8.9%) and 5 (8.9%) episodes, respectively while the most common Gram-negative organisms were Escherichia coli, Klebsiellapneumoniae identified in 13 (23.2%), 8 (14.2%) episodes, respectively. 42 episodes, (32.3%) were considered to be treatment failure. On multivaliable analysis, the number of peritoneal fluid white blood cell count of greater than or equal to 1,090 cell/mm3 at the 3rd day of treatment (Odd ratio 6.28;95%Cl 2.43 to 16.21,p<0.001) and residual urine output volume of less than 200 mL/day (Odd ratio 3.51;95%Cl 1.46 to 8.42, p=0.005)
Key words : Continuous ambulatory peritoneal dialysis, Peritonitis, Catheter removal, End-stage renal disease
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