Risk Factors and Prevention of Peritoneal Dialysis-Related Peritonitis
| Autor: | Liliana Gadola, Eliana Lungo, Carla Poggi, María V. Poggio, Patricia Dominguez, Claudia Cardozo |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty business.industry Health Personnel medicine.medical_treatment Peritonitis General Medicine Middle Aged medicine.disease Peritoneal dialysis Risk Factors Nephrology medicine Humans Female Major complication Intensive care medicine business Peritoneal Dialysis Retrospective Studies Patient education |
| Zdroj: | Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis. 39:119-125 |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.3747/pdi.2017.00287 |
| Popis: | Background Peritonitis is a major complication and the main cause of peritoneal dialysis (PD) failure. The aim of the present study was to evaluate peritonitis risk factors and its prevention with a new peritoneal educational program (NPEP). Methods We performed a retrospective analysis of a cohort of chronic PD patients, older than 16 years, who began PD in the period 1 January 1999 to 31 December 2015 at a Uruguayan PD center, with follow-up until 31 December 2016. Results The population included 222 cases (219 patients, 128 men), median age 59 (interquartile range [IQR] 47.0 – 72.0) years, median time on PD 17.5 (IQR 6.0 – 36.2) months. Ninety-five patients suffered 1 or more episodes of peritonitis, and they had been on PD for a longer period and had nasal-positive culture more frequently. A NPEP started in September 2008; patients who trained with it, as well as younger patients, had longer peritonitis-free survival. After the NPEP, global peritonitis rates decreased significantly (from 0.48 to 0.29 episodes/patient-year, respectively), particularly gram-positive bacteria and Staphylococcus aureus / coagulase-negative (CoNS) (from 0.26 to 0.12 and 0.21 to 0.07 episodes/patient-year, respectively). In the multivariate Cox analysis of peritonitis risk factors, survival to first peritonitis was significantly associated only with age (hazard ratio [HR] 1.024, 95% confidence interval [CI] 1.007 – 1.397, p = 0.007) and the NPEP (HR 0.600, 95% CI 0.394 – 0.913, p = 0.017). Conclusion A multidisciplinary peritoneal educational program may improve peritonitis rates, independently of other risk factors. |
| Databáze: | OpenAIRE |
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