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Abstract: TH-PO405

Feasibility of Resuming Peritoneal Dialysis After Catheter Removal Due to Severe Peritonitis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Chediak, María Cristina, Hospital Ramón y Cajal, Madrid, Spain
  • Sosa Barrios, Haridian, Hospital Ramón y Cajal, Madrid, Spain
  • Burguera, Victor, Hospital Ramón y Cajal, Madrid, Spain
  • Cintra Cabrera, Melissa, Hospital Ramón y Cajal, Madrid, Spain
  • Fernandez lucas, Milagros, Hospital Ramón y Cajal, Madrid, Spain
  • Rivera, Maite, Hospital Ramón y Cajal, Madrid, Spain
Background

The resumption of peritoneal dialysis (PD) after a peritonitis requiring peritoneal catheter (PC) removal is unlikely and remains poorly studied. We analyzed the characteristics and outcomes of patients resuming PD after peritonitis.

Methods

We reviewed all episodes of peritonitis between 1996 and 2017 and identified the cases in which the catheter was removed. We compared the data of patients who restarted PD after PC removal (Group 1) with those who did not (Group 2) and identified the causes.

Results

Of 483 peritonitis episodes, PC was removed in 48 patients (16.9%). Of these, 18 (37.5%) resumed PD and 30 (62.5%) did not.
The median duration of PD before catheter removal was 24.5 months (range 14.2-40) and the number of previous peritonitis episodes was 2 (range 1-3).

The indications for catheter removal were: refractory and relapsing peritonitis; fungal, mycobacterial and polymicrobial peritonitis. The organisms identified were: S. aureus 20.8% (n=10), Candida sp 18.8% (n=9), P. aeruginosa 14.6% (n=7), other Gram-negative bacilli 20.8% (n=10), mixed growth 8.3% (n=4), Mycobacterium sp 6.3% (n=3), other Gram-positive 4.2%( n=2) and no growth 6.3% (n=3).

Group 1 (n=18): 89.9% (n=16) were male, median age was 53 years (range 44 – 64) and Charlson Index was 4 (range 2 – 6). PD was resumed successfully in all with a median duration of PD afterwards of 14.1 months (range 4-69).

Group 2 (n=30): 60% (n=18) were male, median age was 64 years (range 48 – 76) and Charlson Index was 6 (range 4 – 8). Causes of no reinsertion were: death due to peritonitis 16.7% (n = 5), transplantation 6.7% (n = 2) and transfer to hemodialysis (HD) 76.6% (n = 23). HD- switch was due to non- medical reasons in 47.8% (n = 11), including fear of peritonitis 10.4% (n=5), family decision 36.3% (n = 4) and social dependence in 18.2% (n = 2).

Group 1 was younger (p = 0.041), had a higher proportion of men (p = 0.049) and a lower Charlson index (p = 0.045). No other statistically significant difference was found between both groups.

Conclusion

Resuming PD after PC removal is feasible. A high proportion of patients do not restart PD for non-medical reasons, mostly fear of peritonitis and family decision.