Risk factors for peritonitis related to peritoneal dialysis

Abstract

Abstract:Background: The aim of this study was to evaluate risk factors for peritonitis associated with peritoneal dialysis in our centre. Methods: Forty patients on chronic peritoneal dialysis between 2006-2010 were enrolled in this study. Nutritional, sociodemographical, psychological, dialysis related (peritoneal modality, characteristics and adequacy) possible risk factors associated with the development of peritonitis were recorded. Data of patients with and without peritonitis were compared using the Student's t-test and chi-square test.Results: There were 31 episodes of peritonitis among 21 patients, while other 19 patients had not experienced peritonitis resulting in a rate of 1 episode / 44 patient months. Staphylococcus aureus was the most frequent microorganism isolated (31 %). Hypoalbuminemia, technical problems, poor personal and environmental hygiene, low educational status, current or former smoking history and less urine output were observed significantly more in patients who had peritonitis. Conclusions: Our results confi rm that educational, psychological, nutritional, smoking and hygiene status and amount of urine output are closely associated with peritonitis among peritoneal dialysis patients. Measures to improve these factors may help prevent and control peritoneal dialysis related peritonitis (Tab. 4, Ref. 14). Full Text in PDF www.elis.sk. Key words: peritoneal dialysis, peritonitis, low education, hypoalbuminemia, poor hygiene status, low urine output.

Prevalence and impact of anxiety and depression in Chinese peritoneal dialysis patients: A single centre study

“…Peritonitis is one of the leading causes of morbidity and mortality among PD patients. Recent studies suggested that psychological factors could play an important role in the subsequent development of peritonitis . According to the K/DOQI guidelines, the psychological status of each dialysis patient should be evaluated by a social worker upon initiation of dialysis and then at least biannually, with specific focus on the presence of depression, anxiety, and hostility…”

Membrane transport status does not predict peritonitis risk in patients on peritoneal dialysis

“…The association of age and diabetes mellitus with patient survival on PD is consistent with other studies, suggesting that these factors have clinical significance in predicting prognosis of PD patients. An association between smoking status and peritonitis has been noted in previous literature, which may be because cigarette smoke affects both cell‐mediated and humoral‐mediated immune responses, thereby increasing risk of infection . Components of cigarette smoke, including nicotine, have been demonstrated to depress T‐cell proliferation, the phagocytic function of macrophages as well as antibody response .…”

“…Our findings that hypoalbuminaemia is associated with peritonitis and technique failure in PD is consistent with previous literature. [9][10][11]13,16,18 In fact, the increased risk of peritonitis afforded by hypoalbuminaemia may contribute to technique failure, with previous studies also demonstrating that peritonitis is significantly associated with technique failure. 13,19,20 However, the exact mechanism of how hypoalbuminaemia exerts its effect is unknown.…”

“…Although hypoalbuminaemia has been demonstrated to be a risk factor for the development of peritonitis and poorer outcomes on PD, the mechanism by which it exerts its effect is unknown. Hypoalbuminaemia may be a manifestation of peritoneal protein loss that occurs as a result of high MTS.…”

Platelet-to-Lymphocyte Ratio and the First Occurrence of Peritonitis in Peritoneal Dialysis Patients

“…Serum albumin and blood hemoglobin as nutritional and muscle mass surrogate measures have been con rmed to be related to the occurrence of PDRP [30][31][32]. Meanwhile, history of smoking and CVD were also mentioned as risk factors for PDRP in some single-center retrospective studies [33,34].…”