Abstract: FR-PO943

Outcomes of Peritoneal Dialysis Associated Peritonitis in the Elderly Population: A Single Centre Experience

Session Information

  • Geriatric Nephrology
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

  • 901 Geriatric Nephrology

Authors

  • Htay, Htay, Singapore General Hospital, Singapore, Singapore
  • Pang, Suh Chien, Singapore General Hospital, Singapore, Singapore
  • Sim, Mui hian, Singapore General Hospital, Singapore, Singapore
  • Seng, Jun Jie Benjamin, Singapore General Hospital, Singapore, Singapore
  • Wu, Sin yan, Singapore General Hospital, Singapore, Singapore
  • Foo, Marjorie Wai Yin, Singapore General Hospital, Singapore, Singapore
Background

The clinical outcomes of peritonitis in the elderly peritoneal dialysis (PD) patients have not been well studied before. The study aimed to determine the outcomes of peritonitis in elderly patients.

Methods

This was a single centre retrospective cohort study, including all peritonitis episodes between 2011 and 2014. The primary outcome was medical cure (defined as peritonitis episode cured by antibiotics without complicated by catheter removal, haemodialysis (HD) transfer, relapsed/recurrent peritonitis and/or death) in elderly patients, defined as ≥ 65 years old. The secondary outcomes were complications of peritonitis. These outcomes were compared between elderly and younger patients using multivariable logistic regression.

Results

Total 377 episodes of peritonitis occurred in 247 patients during the study period. Of these, 169 episodes occurred in 105 elderly patients. Of 105 elderly, 51% were male, 79% were Chinese, 65% had diabetes mellitus, 95% had hypertension and 54% had cardiovascular disease. Diabetes nephropathy (52%) was the commonest cause of renal failure. The causative organisms were Gram-positive (32%), Gram-negative (29%), culture negative (22%), polymicrobial (12%), fungal (4%) and mycobacterial (1%) organisms. Elderly patients were less likely to present with fever (17% versus 30%) and cloudy effluent (85% versus 92%) than younger patients. Total 112 episodes (66%) of peritonitis in elderly patients achieved medical cure. The remaining 57 episodes were not cured because of one or more of the following complications: catheter removal (n=29), haemodialysis transfer (n=20), relapsed/recurrent peritonitis (n=19), and/or death (n=11). There was no significant difference in the odds of medical cure (Odds ratio (OR) 0.93, 95% confidence interval (CI) 0.56 - 1.54; p=0.78) between the elderly and the younger patients after adjusting for cardiovascular disease, primary renal disease and causative organisms. Similar results were observed for complications of peritonitis (catheter removal, transfer HD, relapase/recurrence) except that the odds of peritonitis-related death was significantly higher in the elderly patients (adjusted OR 2.59, 95% CI 1.07- 6.29; p=0.04).

Conclusion

Elderly PD patients achieved comparable medical cure but had higher peritonitis-related mortality than younger patients.