2022, Number 3
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Rev Nefrol Dial Traspl 2022; 42 (3)
Peritoneal dialysis related peritonitis; a single center results
Ozbek O, Akdam H, Oncu S, Yeniçerioglu Y, Oncu S
Language: English
References: 27
Page: 206-214
PDF size: 302.27 Kb.
ABSTRACT
Introduction: Peritoneal dialysis
(PD) related peritonitis is one of the
most serious complications which
leads to technical failure, transfer
to hemodialysis and mortality.
Objective: We aimed to evaluate
peritonitis rate, clinical outcome, and
mortality in PD patients’ 10-year
follow-up.
Methods: PD-related
peritonitis period of 2009 to 2018
were analyzed, retrospectively.
Demographic features, causative
microorganism, antibiotic resistance,
and biochemical parameters were
obtained from hospital records.
Catheter removal, mortality and
peritonitis rate results were evaluated.
Results: A total of 80 PD-related
peritonitis was detected. The overall
peritonitis rate was 0.24 episode/
year, annually was ranging from
0.14 to 0.53. Gram-positive, gramnegative
and culture negative
peritonitis rate was 58.8%, 21.3%,
%18.8, respectively. Coagulase
negative staphylococcus (30%)
was the most common causative
microorganism and 37.5% of them
were methicillin-resistant, while
100% of Staphylococcus aureus
were sensitive to methicillin.
Peritoneal effluent leukocyte count
at admission was significantly higher
in gram-negative than gram-positive
peritonitis. Peritonitis-associated
catheter removal and mortality rate
were 26.25% and 6.25%, respectively.
C-reactive protein 0
th and 3
rd day,
peritoneal effluent leukocytes and
neutrophils 3
rd day count were
significantly higher and total protein
and albumin 0
th and 3
rd day results
were significantly lower in catheter
removed patients. The catheter
removal was significantly higher in
female patients and in gram-negative
peritonitis. It was found that decrease
in 1g/dL of albumin increases the
probability of catheter removal by
13.8 fold.
Conclusion: Catheter
removal was slightly elevated at our
center. Catheter loss was associated
with female gender, gram-negative
strains, and hypoalbuminemia in
PD-related peritonitis.
REFERENCES
Jain AK, Blake P, Cordy P, Garg AX. Global trendsin rates of peritoneal dialysis. J Am Soc Nephrol. 2012;23(3):533-544. doi: 10.1681/ASN.2011060607.
Bargman JM. Advances in peritoneal dialysis: a review.Semin Dial. 2012; 25(5): 545-549. doi: 10.1111/j.1525-139X.2012.01124.x.
Hansson JH, Watnick S. Update on Peritoneal Dialysis:Core Curriculum 2016. Am J Kidney Dis. 2016; 67(1):151-164. doi: 10.1053/j.ajkd.2015.06.031.
Akoh JA. Peritoneal dialysis associated infections: Anupdate on diagnosis and management. World J Nephrol.2012; 1(4): 106-122. doi: 10.5527/wjn.v1.i4.106.
Salzer WL. Peritoneal dialysis-related peritonitis:challenges and solutions. Int J Nephrol Renovasc Dis.2018; 11: 173-186. doi: 10.2147/IJNRD.S123618.
Moraes TP, Pecoits-Filho R, Ribeiro SC, Rigo M, SilvaMM, Teixeira PS, et al. Peritoneal dialysis in Brazil:twenty-five years of experience in a single center. PeritDial Int. 2009; 29(5): 492-498.
Nieto-Ríos JF, Díaz-Betancur JS, Arbeláez-Gómez M,García-García Á, Rodelo-Ceballos J, Reino-BuelvasA, et al. Peritoneal dialysis-related peritonitis: twentysevenyears of experience in a Colombian medicalcenter. Nefrología 2014; 34(1): 88-95. doi: 10.3265/Nefrologia.pre2013.Nov.12002.
Li PK, Szeto CC, Piraino B, De Arteaga J,Fan S, Figueiredo AE, et al. ISPD peritonitisrecommendations: 2016 update on prevention andtreatment. Perit Dial Int. 2016; 36: 481–508. doi:10.3747/pdi.2016.00078
Saxena R, West C. Peritoneal dialysis: a primary careperspective. J Am Board Fam Med. 2006;19(4):380-9.doi: 10.3122/jabfm.19.4.380
Shahab I, Khanna R, Nolph KD. Peritoneal dialysisor hemodialysis? A dilemma for the nephrologist. AdvPerit Dial. 2006;22:180-185.
Lukowsky LR, Mehrotra R, Kheifets L, Arah OA,Nissenson AR, Kalantar-Zadeh K. Comparingmortality of peritoneal and hemodialysis patients in thefirst 2 years of dialysis therapy: a marginal structuralmodel analysis. Clin J Am Soc Nephrol. 2013;8(4):619-628. doi: 10.2215/CJN.04810512.
Figueiredo AE, Poli-de-Figueiredo CE, MeneghettiF, Lise GA, Detofoli CC, Silva LB. Peritonitis inpatients on peritoneal dialysis: analysis of a singleBrazilian center based on the International Society forPeritoneal Dialysis. J Bras Nefrol. 2013; 35(3):214-219.doi: 10.5935/0101-2800.20130034.
Fernández P, Ledesma F, Douthat W, ChiurchiuC, Vilaró M, Abiega C, De la Fuente J, De ArteagaJ. Peritonitis in Peritoneal Dialysis. Epidemiology,Risk Factors, Inclusion of BACTEC™ in TraditionalCulture Systems, and Long-Term Mortality. Rev NefrolDial Traspl. 2017; 37: 81-88.
Tekkarişmaz N, Torun D. Long-term clinicaloutcomes of peritoneal dialysis patients: 9-yearexperience of a single centre in Turkey. Turk J Med Sci.2020; 50(2):386-397. doi: 10.3906/sag-1909-98.
Tian Y, Xie X, Xiang S, Yang X, Lin J, Zhang X,et al. Risk Factors and Outcomes of Early-OnsetPeritonitis in Chinese Peritoneal Dialysis Patients.Kidney Blood Press Res. 2017;42(6):1266-1276. doi:10.1159/000485930.
Lan PG, Johnson DW, McDonald SP, Boudville N,Borlace M, Badve SV, et al. The association betweenperitoneal dialysis modality and peritonitis. Clin JAm Soc Nephrol. 2014;9(6):1091-1097. doi: 10.2215/CJN.09730913.
Rabindranath KS, Adams J, Ali TZ, Daly C, ValeL, Macleod AM, et al. Automated vs continuousambulatory peritoneal dialysis: A systematic review ofrandomized controlled trials. Nephrol Dial Transplant.2007;(10):2991-2998. doi: 10.1093/ndt/gfm515.
Kitterer D, Latus J, Alscher MD, Kimmel M,Infectious Complications in Peritoneal Dialysis: TheSpectrum of Causative Organisms and RecommendedTreatment Options. In: Ekart R (editors). Some SpecialProblems in Peritoneal Dialysis. London: IntechOpen;2016.pp.95-112. doi: 10.5772/64005
Surbatovic M, Popovic N, Vojvodic D, MilosevicI, Acimovic G, Stojicic M, et al. Cytokine profile insevere Gram-positive and Gram-negative abdominalsepsis. Sci Rep. 2015; 5:11355. doi: 10.1038/srep11355.
Lye WC, Wong PL, Leong SO, Lee EJ. Isolation oforganisms in CAPD peritonitis: a comparison of twotechniques. Adv Perit Dial. 1994;10:166-168.
Mujais S. Microbiology and outcomes of peritonitisin North America. Kidney Int Suppl. 2006;103:55-62.doi: 10.1038/sj.ki.5001916.
Kocyigit I, Unal A, Karademir D, Bahcebasi S,Sipahioglu MH, Tokgoz B, et al. Improvementin culture-negative peritoneal dialysis-relatedperitonitis: a single center’s experience. Perit Dial Int.2012;32(4):476-478. doi:10.3747/pdi.2011.00153.
Szeto CC, Kwan BC, Chow KM, Lau MF, Law MC,Chung KY, et al. Coagulase negative staphylococcalperitonitis in peritoneal dialysis patients: review of 232consecutive cases. Clin J Am Soc Nephrol. 2008;3(1):91-97. doi: 10.2215/CJN.03070707.
Choi P, Nemati E, Banerjee A, Preston E, Levy J,Brown E. Peritoneal dialysis catheter removal for acuteperitonitis: a retrospective analysis of factors associatedwith catheter removal and prolonged postoperativehospitalization. Am J Kidney Dis. 2004;43(1):103-11.doi: 10.1053/j.ajkd.2003.08.046.
Ram R, Swarnalatha G, Rao CS, Naidu GD, SriramS, Dakshinamurty KV. Risk factors that determineremoval of the catheter in bacterial peritonitis inperitoneal dialysis. Perit Dial Int. 2014;34(2):239-43.doi:10.3747/pdi.2012.00343.
Wang T, Heimbürger O, Bergström J, LindholmB. Nutritional problems in peritoneal dialysis: anoverview. Perit Dial Int. 1999;19 Suppl 2:297-303.doi:10.1177/089686089901902S50.
Rodríguez-García VH, López-Guerra EA, Rodríguez-Castellanos FE. Association between peritoneal proteinexcretion, peritonitis and D/P phosphate, in patientson peritoneal dialysis. Nefrología 2013;33(2):204-213.doi: 10.3265/Nefrologia.pre2012.Oct.11651.