ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

Abstract

Patient population (n) Episodes per Country Reference Year Adults Children Centers year at risk (n) Scotland Kavanaugh (1) 2004 1205 a 0.62 Japan Hoshii (2) 2006 130 0.17 Canada Mujais (3) 2006 26 0.43 United States Mujais (3) 2006 35 a 0.37 Japan Nakamoto (4

Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes

“…Results are presented as number (%), mean 6 SD, or median (range 20,21 However, these studies have had significant limitations. In the EuroBalance trial, 8 Balance solution was associated with significant increases in renal urea and creatinine clearances over 12 weeks in 86 prevalent PD patients compared with conventional solution.…”

Hand Hygiene in Peritoneal Dialysis Patients: A Comparison of Two Techniques

“…We collected samples in two stages, during scheduled appointments on different days, in a secluded area used by the PD program. We informed all patients about the nature of each technique before starting the process, and all patients received identical training for reducing the risk of PD infections (17,18). We evaluated HH efficacy in relation to transient and resident flora (S. aureus and CNS) after application of the two HH techniques already in use.…”

Getting Excited about Exit Sites in Peritoneal Dialysis?

“…The data presented support rather than raise doubts about the hypothesis that ESI leads to peritonitis. As the authors propose, this area needs further investigation, but there is nothing in their findings to support a change in presently recommended practices (7,21). Acutely infected exit sites should be identified, cultured, and treated aggressively.…”

“…Persistent exit site infection with clinical involvement of the tunnel, despite antibiotic treatment, should lead to consideration of catheter removal, especially if the organism is Pseudomonas or S. aureus, because progression to an unpleasant peritonitis is otherwise likely. Even more importantly, preventative strategies should be used (7). It is hard to understand why all centers do not use either topical mupirocin or topical gentamicin, given the published literature (12,13).…”

“…These are touch contamination by the patient during connection procedures, migration of organisms from the exit site through the catheter tunnel, and transmural migration from the gut into the peritoneal cavity (7).…”