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Portuguese Journal of Nephrology & Hypertension

versão impressa ISSN 0872-0169

Resumo

COSTA, Rui et al. Peritoneal dialysis-related peritonitis in 10 years: a single-centre experience. Port J Nephrol Hypert [online]. 2013, vol.27, n.1, pp.31-40. ISSN 0872-0169.

Aims: Evaluate the incidence, aetiology, predictors and outcomes of peritonitis in our chronic peritoneal dialysis (PD) patients. Patients and methods: A retrospective observational study was carried out in 59 patients during a ten-year period, which included the epidemiology, clinical presentation, microbiology profile, treatment and outcomes of all peritonitis episodes. Results: A total of 88 peritonitis occurred in 31 patients (mean age 43 ±15 years), with a peritonitis rate of 0.57 episodes.patient.year. Male gender (68.0% vs. 39.0%, p < 0.01) was associated with events. Coagulase-negative Staphylococcus was the most frequent agent (25.9%). Staphylococcus aureus peritonitis (17.0%) was associated with repeat peritonitis (44.4% vs. 14.3%, p = 0.02). Nasal carriage of this agent was found in half the patients and five (33.3%) episodes were preceded by exit-site infection. Culture negative peritonitis (15.9%) had lower initial peritoneal leukocyte count (< 1500 cell/mm3: 64.3% vs. 32.4%, p = 0.02). Eleven refractory peritonitis were reported and associated with longer time of treatment (34 vs. 20 days, p < 0.01) and hospital stay (16 vs. 5 days, p < 0.01). The peritoneal catheter was removed in eight cases. Cure was achieved in the majority of cases (n = 80; 90.9%), seven patients were transferred to haemodialysis, and one died. The technique survival rate at 36 months was 80%. Greater risk of peritonitis in the first year was identified in patients transferred from haemodialysis (OR 5.9; CI 95%: 1.2 -29.3) and male gender (OR 5.1; CI 95%: 1.02 - 25.1). Considering all PD patients, first year peritoneal dialysis episode was associated with higher risk for cumulative peritonitis (≥ 3) (OR 10.28; CI 95%: 1.27 -83.32). Diabetes and older age were not associated to higher risk of these events. Conclusion: The overall results of peritonitis episodes were satisfactory. Transfer from haemodialysis and male gender were associated with higher risk for first -year peritonitis. This early event was associated with a greater risk of occurrence of three or more peritonitis in those patients.

Palavras-chave : Outcome; peritoneal dialysis; peritonitis; predictors.

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