Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study

Abstract

BackgroundColonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. However, no study has yet described the risk factors in play.MethodsThis was a retrospective multicentre study. The medical records of patients on continuous ambulatory peritoneal dialysis (CAPD) who underwent colonoscopy from January 2003 to December 2012 were analysed. We recorded demographic characteristics, colonoscopic factors, use of prophylactic antibiotics, and development of peritonitis. Colonoscopy-related peritonitis was defined as peritonitis developing within 1 week after colonoscopy. Demographic and clinical characteristics were compared between patients who did and those who did not develop peritonitis.ResultsDuring the study period, 236 patients on CAPD underwent colonoscopy, of whom 9 (3.8%) developed peritonitis. The rates of polypectomy/endoscopic mucosal resection were significantly higher in the peritonitis group than in the no peritonitis group (66.7 vs. 23.4%, p = 0.009). Prophylactic antibiotics were prescribed before colonoscopy in 65 patients; none developed peritonitis. No patient who developed peritonitis received prophylactic antibiotics (p = 0.067).ConclusionsAdvanced procedures including polypectomy or endoscopic mucosal resection increase colonoscopy-related peritonitis in patients on CAPD. Randomized controlled trials to investigate whether prophylactic antibiotics are needed to prevent peritonitis in all CAPD patients are warranted.

Risk of peritonitis after gastroscopy in peritoneal dialysis patients

“…A large observational study in Korea reported 3.8% incidence rate of peritonitis in 236 PD patients who underwent colonoscopy. 16 This is in fact very similar to our reported rate of peritonitis after gastroscopy. Our results, in other words, confirm that peritonitis after upper gastrointestinal endoscopy is not uncommon.…”

ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment

“…58 Reported rates of peritonitis after colonoscopy without antibiotic prophylaxis ranged between 3.4% and 8.5%. 55,56 The rates of peritonitis after gastroscopy in PD patients range from 1.2% 58 to 3.9%. 59…”

“…57 More than half of reported peritonitis episodes occurring after colonoscopy are caused by E. coli. 55,60 In a single-centre study of 97 colonoscopies performed in 77 continuous ambulatory peritoneal dialysis (CAPD) patients, none of the 18 patients having a colonoscopy procedure with antibiotic prophylaxis developed peritonitis, as opposed to a 6.3% peritonitis occurrence among those undergoing colonoscopy without antibiotic prophylaxis. 50 This is consistent with a more extensive multicentre study of 236 colonoscopy procedures, in which none of the 65 patients who received antibiotic prophylaxis developed peritonitis, compared to a peritonitis rate of 3.8% for those without prophylactic antibiotics.…”

Assesment of Health-Related Quality of Life with Patient Chronic Kidney Disease

“…Patients over 55 years of age are more likely to develop complications that can aggravate kidney function to work compared to patients under 40 years of age. 2019) which shows that the majority of respondents are from college, the higher the level of education of a person, the awareness of the importance of health and treatment of the health problems they face will also be more likely to think positively [9]. The latest education status also affects the economic and social resources achieved, so that a paradigm appears that a low level of education results in an individual having low knowledge of their own health and increases the risk of chronic kidney disease [7].…”