Recent analysis of status and outcomes of peritoneal dialysis in the Tokai area of Japan: the second report of the Tokai peritoneal dialysis registry

Abstract

Our efforts at education might have been useful for improving early withdrawal from PD and deaths attributable to PD-related peritonitis. However, since improvements to incidence of PD-related peritonitis were limited by education, further improvement in PD-related peritonitis incidence requires development of new sterilized connecting systems during PD-bag exchanges to decrease PD-related peritonitis opportunities. Construction of medical support systems to address social problems is required to maintain long-term PD therapy.

Successful Introduction of Peritoneal Dialysis in an End-stage Renal Failure Patient with Idiopathic Aplastic Anemia

“…To address these problems, we maintained the platelet count at 5×10 4 /mm 3 to prevent surgical intervention-related bleeding and 3×10 4 /mm 3 to prevent exitsite bleeding and unexpected intraabdominal bleeding related to the PD catheter, according to the guidelines for platelet infusions in patients with thrombocytopenia and other reports (9-11). Since PD-related peritonitis mainly occurs due to touch-contamination during the bag-change process at our hospital, as has also been previously reported (16)(17)(18)(19)(20), we introduced a new UV-sterilization device system, called "TSUNAGU" (Baxter Co.), which does not require the removal of the protective cover when connecting a new PDF bag. This system might be better able to maintain a sterile environment during most bag change procedures than the conventional "Clean Flash" UV-device system (Baxter Co.), which requires the protective cap be removed from the connecting tube by hand when changing PDF bags.…”

Peritonitis-induced peritoneal injury models for research in peritoneal dialysis review of infectious and non-infectious models

“…PD peritonitis is primarily caused by gram-positive organisms that typically result from touch contamination. The mean incidence of peritonitis as reported twice from a study over a 3-year period was one episode every 42.8 [4] and 47.3 [5] patient-months. Third, peritonitis presents a risk for the development of encapsulating peritoneal sclerosis (EPS) [6].…”

“…Second, peritonitis remains an important factor in withdrawal from PD. In the PD registry of the Nagoya group from both 2005 to 2007 [4] and 2010 to 2012 [5], the most common reasons for withdrawal from PD have been PD-related peritonitis, followed by dialysis failure/ultrafiltration failure and social problems such as lack of family support. PD peritonitis is primarily caused by gram-positive organisms that typically result from touch contamination.…”

Impact of hypokalemia on peritonitis in peritoneal dialysis patients: a systematic review

“…It is well known that peritonitis is the major reason for withdrawal of peritoneal dialysis [1,2]. Candidates for renal replacement therapy often hesitate to select peritoneal dialysis due to fear of the possibility of peritonitis.…”

“…In spite of those efforts of prevention of peritonitis, peritoneal dialysisassociated peritonitis rates have not been reduced sufficiently [1,4]. Even the introduction of disconnect systems has not been dramatically improved the risk of peritonitis [5,6].…”