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Abstract: TH-PO404

Peritonitis Before Peritoneal Dialysis Training: A Single Center Experience

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Mon, Saw Yu, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Mahmood, Usman, Toowoomba Hospital, Toowoomba, Queensland, Australia
  • Hawley, Carmel M., Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Fahim, Magid, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Cho, Yeoung Jee, Princess Alexandra Hospital, Brisbane, Queensland, Australia
Background

Peritoneal dialysis (PD)-related peritonitis is an important risk factor for death and technique failure in PD patients. The predictors and outcomes of peritonitis prior to commencing PD (pre-training peritonitis [PTP]) are poorly understood. The aim of this study was to examine risk factors and long-term patient outcomes in those who experience PTP.

Methods

This single-center, matched case-control study included patients commencing PD from 1January 2005 to 31December 2015. PTP patients were matched 1:3 with those who developed peritonitis after PD training,based on tertiles of age and diabetic status. We examined risk factors for PTP,immediate and long-term outcomes, including technique and patient survival.

Results

Thirty-eight patients with PTP were identified and matched to 114 control patients. Compared to controls,PTP patients were significantly more likely to have history of hypertension (100% vs 89%, p=0.04),late nephrologist referral (21% vs 9%,p=0.04),open surgical PD catheter insertion (82% vs 44%,p<0.001),and pre-training exit site infection (34% vs 2%,p<0.001). PTP patients experienced comparable rates of peritonitis cure (58% vs 65%, p=0.50),temporary haemodialysis transfer (13% vs 11%,p=0.77),technique survival (HR 1.47, 95% CI 0.94-2.29,p=0.09) and patient survival (HR 1.35, 95% CI 0.52-3.49,p=0.54). There was a significant two-way interaction between history of ischaemic heart disease (IHD) and PTP status (p=0.02), such that technique failure risk was increased in PTP patients with IHD (HR 2.82, 95% CI 1.37-5.84,p=0.005) but not those without IHD (HR 0.88, 95% CI 0.41-1.92,p=0.75).

Conclusion

The risk of PTP was increased by factors relating to patient, catheter insertion approach and clinical events. Patient outcomes were comparable between PTP and post-training peritonitis, except for a greater risk of technique failure in patients with PTP and IHD.

Technique survival for PTP group compared with non-PTP group