Risk Factors of Peritonitis in Patients Receiving Peritoneal Dialysis, Vachira Phuket Hospital

Abstract

Objectives: To investigate the cumulative incidence, clinical characteristics, risk factors for peritonitis, and treatment outcomes of peritonitis in patients undergoing peritoneal dialysis. Method: A retrospective descriptive study was conducted on peritoneal dialysis patients at Vachira Phuket Hospital during the fiscal years 2021-2023. The data collection tools were examined for validity and reliability. Data were analyzed using chi-square statistics and point biserial correlation coefficient and for selecting the variables to be included in the prediction model using binary logistic regression. Results: The cumulative number of peritoneal dialysis patients during fiscal years 2021–2023 was 481. Peritonitis occurred in 191 patients (39.70%), with the number of infectious episodes ranging from 1 to 5, averaging 1.54 times per person. The factors associated with peritonitis were serum albumin levels, daily urine output, daily house cleaning, having pets in the house, handwashing, wearing masks, adherence to peritoneal dialysis procedures, and the location of dialysis fluid exchange. The analysis of predictive factors revealed that handwashing and wearing masks were significant factors in preventing peritonitis. (2021 Odds ratio (OR) = 0.073, 95%CI = 0.019, 0.284; 2022 OR = 0.061, 95%CI = 0.020, 0.183; 2023 OR = 0.046, 95%CI = 0.013, 0.155). The variables in the prediction model jointly explained 49.6% to 52.9% of the occurrence of peritonitis. The median treatment cost for peritonitis ranged from 17,619.27 to 43,660 baht. Conclusion: Peritonitis can be prevented by improving handwashing and wearing masks with close monitoring of adherence to dialysis procedures and home visits with the involvement of community networks to ensure correct practice. This approach will enhance patient safety and quality of life.