Frequent peritoneal dialysis-related peritonitis: clinical characteristics, risk factors and treatments / 南方医科大学学报

ABSTRACT

<p><b>OBJECTIVE</b>To identify the clinical characteristics and risk factors of frequent peritoneal dialysis (PD)-related peritonitis.</p><p><b>METHODS</b>A retrospective analysis was conducted in the peritonitis patients undergoing continuous ambulatory peritoneal dialysis (CAPD) in our hospital. Frequent PD-related peritonitis was defined by two or more onsets in one year, and the patients with only one onset served as the control group. The clinical and laboratory data of the two groups were compared and the risk factors of PD-related peritonitis analyzed.</p><p><b>RESULTS</b>Forty-four episodes of peritonitis were recorded in the 16 patients with frequent PD-related peritonitis, as compared to 53 episodes in the 45 control patients. Compared with those in the control group, the patients with frequent peritonitis had significantly higher blood pressure (P<or=0.05) but lower hemoglobulin (P<or=0.05) and plasma albumin (P<or=0.01), with higher rates of edema (P<or=0.01), gram-negative bacteria and fungal infection (P<or=0.05) and PD catheter removal (P<or=0.05). No significant differences were found between the two groups in age, mode of catheter placement surgery, intervals between PD initiation and peritonitis occurrence, inducing factors of peritonitis, incidence of dyspnea, serum creatinin, urea, calcium, mineral phosphorus, blood or dialysate leucocytes (P>0.05). Variables identified to be associated with an increased likelihood of frequent PD-related peritonitis included hemoglobulin<70 g/L (OR=0.135, P<or=0.01) and plasma albumin<30 g/L (OR=0.181, P<or=0.05).</p><p><b>CONCLUSION</b>Compared with the patients with only one annual occurrence of peritonitis, the patients with frequent PD-related peritonitis have severer malnutrition and water overload, which are probably correlated to the high rates of PD catheter removal and poor prognosis. Severe anemia and proteinemia are risk factors and also predictive factors of frequent PD-related peritonitis. Measures to ameliorate anemia and proteinemia and effective management of celiac endogenous infection may help prevent and control frequent PD-related peritonitis.</p>