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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
FactorsAdjusted OR (95% CI)P ValueFactorsAdjusted OR (95% CI)P Value
PD with assistance  Causative organisms  
● AloneReference Gram-positive only (excluding MRSA)Reference 
● With family1.39 (0.80 – 2.39)
0.238MRSA0.95 (0.06 – 16.16)
0.969
● With others15.42 (4.74 – 50.15)
< 0.001Gram-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
● < 905.15 (1.42 – 18.69)
0.013Pseudomonas spp.3.72 (1.02 – 13.56)
0.046
● 90-140Reference Fungi48.37 (4.52 – 518.12)
0.001
● > 1401.75 (1.01 – 3.04)
0.046Mycobacterial4.17 (0.58 – 30.03
0.156
Peritoneal dialysate white count on day 5 > 100/mm3  Polymicrobial7.51 (3.42 – 16.52)
< 0.001
● NoReference Culture negative1.22 (0.66 – 2.25)
0.523
● Yes70.66 (34.94 – 142.92)
< 0.001   

CI, confidence interval; Methicillin-resistant Staphylococcus aureus, OR, odds ratio

Funding

  • Government Support - Non-U.S.