Abstract: SA-PO721
Peritonitis and Predictors of Treatment Failure in Peritoneal Dialysis Patients: An Experience of 902 Consecutive Episodes in Thai Centers
Session Information
- Peritoneal Dialysis - II
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 608 Peritoneal Dialysis
Authors
- Chaisai, Chayutthaphong, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
- nochaiwong, surapon, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
- Ruengorn, Chidchanok, Facultty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
- Koyratkoson, Kiatkriangkrai, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
- Noppakun, Kajohnsak, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Awiphan, Ratanaporn -, Chiangmai University, Chiangmai, Thailand
- Chongruksut, Wilaiwan -, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Nanta, Sirisak, Maesai District Hospital, Chiang Rai, Thailand, Chiang Rai, Thailand
Group or Team Name
- Thai Renal Outcomes Research (THOR) Investigators
Background
Peritonitis is a common cause of peritoneal dialysis (PD) technique failure as well as a major contributing cause of death in PD patients. Early prediction of treatment outcomes can be major potential subsequent management for PD-related peritonitis. To date, existing evidences regarding the prognostic factors for treatment failure are scarce. We therefore determine factors predicted treatment failure among PD-related peritonitis.
Methods
A multicenter, retrospective observational study was based on the PD registry database of patients aged ≥ 18 from three PD center in Thailand. Baseline sociodemographics and laboratory examination characteristics were collected between January 2006 and December 2016. Treatment failure was defined as catheter removal or peritonitis-associated death. Predictors related to treatment failure were investigated by univariable and multivariable logistic regression.
Results
A total of 902 PD-related peritonitis episodes were included, 224 (24.8%) of which had treatment failure. Of those, 157 (17.4%) required Teckhoff catheter removal and 67 (7.4) had peritonitis-associated death.
Conclusion
In order to make a decision, four key predictors from this study may potentially help to identify patients at risk of treatment failure. Early establishment of the severity of PD-related peritonitis may offer opportunities to improve treatment outcomes.
Factors Predicted Treatment Failure among PD-Related Peritonitis by Multivariable Logistic Regression Analysis
| Factors | Adjusted OR (95% CI) | P Value | Factors | Adjusted OR (95% CI) | P Value |
| PD with assistance | Causative organisms | ||||
| ● Alone | Reference | Gram-positive only (excluding MRSA) | Reference | ||
| ● With family | 1.39 (0.80 – 2.39) | 0.238 | MRSA | 0.95 (0.06 – 16.16) | 0.969 |
| ● With others | 15.42 (4.74 – 50.15) | < 0.001 | Gram-negative only (excluding Acinetobacter spp. and Pseudomonas spp.) | 2.29 (0.75 – 6.97) | 0.144 |
| Systolic blood pressure, mmHg | Acinetobacter spp. | 11.97 (3.05 – 46.98) | < 0.001 | ||
| ● < 90 | 5.15 (1.42 – 18.69) | 0.013 | Pseudomonas spp. | 3.72 (1.02 – 13.56) | 0.046 |
| ● 90-140 | Reference | Fungi | 48.37 (4.52 – 518.12) | 0.001 | |
| ● > 140 | 1.75 (1.01 – 3.04) | 0.046 | Mycobacterial | 4.17 (0.58 – 30.03 | 0.156 |
| Peritoneal dialysate white count on day 5 > 100/mm3 | Polymicrobial | 7.51 (3.42 – 16.52) | < 0.001 | ||
| ● No | Reference | Culture negative | 1.22 (0.66 – 2.25) | 0.523 | |
| ● Yes | 70.66 (34.94 – 142.92) | < 0.001 |
CI, confidence interval; Methicillin-resistant Staphylococcus aureus, OR, odds ratio
Funding
- Government Support - Non-U.S.