Lucas Jacobs1, Philippe Clevenbergh2, Frédéric Collart3, Isabelle Brayer3, Maria Mesquita3, Maxime Taghavi3, Christelle Fosso3, Saleh Kaysi3, Joëlle Nortier3, Max Dratwa3. 1. Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique. Electronic address: jacobs.lucas95@gmail.com. 2. Clinique des maladies infectieuses, Département de médecine interne, Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique. 3. Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique.
Abstract
BACKGROUND: Peritonitis is a common complication of chronic peritoneal dialysis treatment contributing to both technique failure and/or death. Little is effectively known about the actual benefits of a continuous training program on peritonitis rates. In the present study, we measured the impact of our patients' training protocol on peritonitis rates. We further studied which consequences the COVID-related disruption of our follow-up program had on peritonitis rates. METHODS: We present our yearly peritonitis rates since our patients' training and retraining program was implemented in 2010. We then focused our study on three consecutive years: 2019, 2020 (emergence of COVID-19), and 2021, collecting microbiological data from each peritonitis episode. Statistical analysis were used to corroborate our findings. RESULTS: Since 2010, peritonitis rates declined linearly (R2=0,6556; df=8; P<0.01) until its nadir in 2019 with 4 peritonitis episodes. The majority of infections were then treated in the outpatient Clinic. In 2020, our continuous technique evaluation decreased by 51% and 28 peritonitis episodes occurred, 47% secondary to strict cutaneous bacteria's, and 31% gastro-intestinal, irrespective of patients' experience or peritoneal dialysis modality. The hospitalization rate reached 71%. Having restored our protocol, we decreased peritonitis rates by 50% in 2021. CONCLUSIONS: Risk factors for peritonitis are identifiable and modifiable and require sustained intervention, continuous visual monitoring and training. These interventions significantly reduce peritonitis rates. Any brief interruption to patients' technique evaluation may elevate peritonitis rates significantly.
BACKGROUND: Peritonitis is a common complication of chronic peritoneal dialysis treatment contributing to both technique failure and/or death. Little is effectively known about the actual benefits of a continuous training program on peritonitis rates. In the present study, we measured the impact of our patients' training protocol on peritonitis rates. We further studied which consequences the COVID-related disruption of our follow-up program had on peritonitis rates. METHODS: We present our yearly peritonitis rates since our patients' training and retraining program was implemented in 2010. We then focused our study on three consecutive years: 2019, 2020 (emergence of COVID-19), and 2021, collecting microbiological data from each peritonitis episode. Statistical analysis were used to corroborate our findings. RESULTS: Since 2010, peritonitis rates declined linearly (R2=0,6556; df=8; P<0.01) until its nadir in 2019 with 4 peritonitis episodes. The majority of infections were then treated in the outpatient Clinic. In 2020, our continuous technique evaluation decreased by 51% and 28 peritonitis episodes occurred, 47% secondary to strict cutaneous bacteria's, and 31% gastro-intestinal, irrespective of patients' experience or peritoneal dialysis modality. The hospitalization rate reached 71%. Having restored our protocol, we decreased peritonitis rates by 50% in 2021. CONCLUSIONS: Risk factors for peritonitis are identifiable and modifiable and require sustained intervention, continuous visual monitoring and training. These interventions significantly reduce peritonitis rates. Any brief interruption to patients' technique evaluation may elevate peritonitis rates significantly.
Authors: Luis C Martin; Jacqueline C T Caramori; Natalia Fernandes; Jose C Divino-Filho; Roberto Pecoits-Filho; Pasqual Barretti Journal: Clin J Am Soc Nephrol Date: 2011-07-07 Impact factor: 8.237
Authors: R Russo; L Manili; G Tiraboschi; K Amar; M De Luca; E Alberghini; P Ghiringhelli; A De Vecchi; M T Porri; G Marinangeli; R Rocca; V Paris; L Ballerini Journal: Kidney Int Suppl Date: 2006-11 Impact factor: 10.545
Authors: Philip Kam-Tao Li; Kai Ming Chow; Yeoungjee Cho; Stanley Fan; Ana E Figueiredo; Tess Harris; Talerngsak Kanjanabuch; Yong-Lim Kim; Magdalena Madero; Jolanta Malyszko; Rajnish Mehrotra; Ikechi G Okpechi; Jeff Perl; Beth Piraino; Naomi Runnegar; Isaac Teitelbaum; Jennifer Ka-Wah Wong; Xueqing Yu; David W Johnson Journal: Perit Dial Int Date: 2022-03 Impact factor: 1.756