INTRODUCTION: Peritonitis remains the main cause of peritoneal dialysis (PD) technique failure worldwide, despite significant reductions in infection rates observed over the past decades. Several studies have described risk factors for peritonitis, technique failure and mortality. However, there are scarce data regarding predictors of complications during and after a peritonitis episode. The aim of our study was to analyze predictors of peritonitis-related outcome in the Brazilian Peritoneal Dialysis study (BRAZPD) cohort. METHODS: All adult incident patients recruited in the BRAZPD Study between December 2004 and October 2007, who remained at least 90 days on PD and presented their first peritonitis episode (n = 474 patients) were included in the study. The endpoints analyzed were non-resolution, death due to a peritonitis episode and long-term technique survival after a peritonitis episode. RESULTS: In the multivariable regression, non-resolution was independently associated with older age (odds ratio (OR) 1.02; p < 0.01), collagenosis as the primary renal disease (OR 4.6; p < 0.05) and Pseudomonas spp as etiological agent (OR 2.9; p < 0.05). Patients who were transferred from APD to CAPD during peritonitis therapy presented a higher risk of non-response (OR 2.5; p < 0.05). The only factor associated with death during a peritonitis episode was older age (OR 1.04; p < 0.05). Exposure to vancomycin and male gender were the independent predictors of long-term technique failure (OR 2.2; p < 0.01). CONCLUSION: Apart from confirming previous observations of the negative impact of older age and Pseudomonas spp peritonitis on outcomes, we observed that collagenosis may negatively impact response to treatment and exposure to vancomycin may possibly reduce long-term technique survival. It is important to emphasize that the association of vancomycin with technique failure does not prove causality. These findings shed light on new factors predicting outcome when peritonitis is diagnosed.
INTRODUCTION:Peritonitis remains the main cause of peritoneal dialysis (PD) technique failure worldwide, despite significant reductions in infection rates observed over the past decades. Several studies have described risk factors for peritonitis, technique failure and mortality. However, there are scarce data regarding predictors of complications during and after a peritonitis episode. The aim of our study was to analyze predictors of peritonitis-related outcome in the Brazilian Peritoneal Dialysis study (BRAZPD) cohort. METHODS: All adult incident patients recruited in the BRAZPD Study between December 2004 and October 2007, who remained at least 90 days on PD and presented their first peritonitis episode (n = 474 patients) were included in the study. The endpoints analyzed were non-resolution, death due to a peritonitis episode and long-term technique survival after a peritonitis episode. RESULTS: In the multivariable regression, non-resolution was independently associated with older age (odds ratio (OR) 1.02; p < 0.01), collagenosis as the primary renal disease (OR 4.6; p < 0.05) and Pseudomonas spp as etiological agent (OR 2.9; p < 0.05). Patients who were transferred from APD to CAPD during peritonitis therapy presented a higher risk of non-response (OR 2.5; p < 0.05). The only factor associated with death during a peritonitis episode was older age (OR 1.04; p < 0.05). Exposure to vancomycin and male gender were the independent predictors of long-term technique failure (OR 2.2; p < 0.01). CONCLUSION: Apart from confirming previous observations of the negative impact of older age and Pseudomonas spp peritonitis on outcomes, we observed that collagenosis may negatively impact response to treatment and exposure to vancomycin may possibly reduce long-term technique survival. It is important to emphasize that the association of vancomycin with technique failure does not prove causality. These findings shed light on new factors predicting outcome when peritonitis is diagnosed.
Authors: Beth Piraino; George R Bailie; Judith Bernardini; Elisabeth Boeschoten; Amit Gupta; Clifford Holmes; Ed J Kuijper; Philip Kam-Tao Li; Wai-Choong Lye; Salim Mujais; David L Paterson; Miguel Perez Fontan; Alfonso Ramos; Franz Schaefer; Linda Uttley Journal: Perit Dial Int Date: 2005 Mar-Apr Impact factor: 1.756
Authors: Yui Pong Siu; Kay Tai Leung; Matthew Ka Hang Tong; Tze Hoi Kwan; Chi Chiu Mok Journal: Nephrol Dial Transplant Date: 2005-10-04 Impact factor: 5.992
Authors: Jenny I Shen; Aya A Mitani; Anjali B Saxena; Benjamin A Goldstein; Wolfgang C Winkelmayer Journal: Perit Dial Int Date: 2012-10-02 Impact factor: 1.756
Authors: Murilo Guedes; Liz Wallim; Camila R Guetter; Yue Jiao; Vladimir Rigodon; Chance Mysayphonh; Len A Usvyat; Pasqual Barretti; Peter Kotanko; John W Larkin; Franklin W Maddux; Roberto Pecoits-Filho; Thyago Proenca de Moraes Journal: PLoS One Date: 2022-06-24 Impact factor: 3.752
Authors: Ana Cláudia Moro Lima Dos Santos; Aydir Cecília Marinho Monteiro; Thaís Alves Barbosa; Danilo Flávio Moraes Riboli; Carlos Henrique Camargo; Adriano Martison Ferreira; Alessandro Lia Mondelli; Augusto Cezar Montelli; Rodrigo Tavanelli Hernandes; Maria de Lourdes Ribeiro de Souza da Cunha; Pasqual Barretti Journal: Pathogens Date: 2022-02-08
Authors: Philip Kam-Tao Li; Cheuk Chun Szeto; Beth Piraino; Javier de Arteaga; Stanley Fan; Ana E Figueiredo; Douglas N Fish; Eric Goffin; Yong-Lim Kim; William Salzer; Dirk G Struijk; Isaac Teitelbaum; David W Johnson Journal: Perit Dial Int Date: 2016-06-09 Impact factor: 1.756