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Abstract: FR-PO489

A Dominican Republic National Health System Retrospective Multicenter Peritonitis Study in Peritoneal Dialysis Patients According to the 2022 ISPD Guidelines

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Campos, Erwin I., Macrotech, Santo Domingo, Dominican Republic
  • Polanco, Elianny S., Macrotech, Santo Domingo, Dominican Republic
  • Hernandez-Ordonez, Sergio O., Macrotech, Santo Domingo, Dominican Republic
  • Aquey, Mercedes, Macrotech, Santo Domingo, Dominican Republic
  • Guzman Chavez, Janny, Macrotech, Santo Domingo, Dominican Republic
  • Cuevas Budhart, Miguel Angel, Instituto Mexicano del Seguro Social, Ciudad de Mexico, DF, Mexico
  • Divino-Filho, Jose C., Division of Renal Medicine, CLINTEC, Stockholm, Sweden
  • Ramos, Alfonso, Macrotech, Santo Domingo, Dominican Republic

Group or Team Name

  • Macrotech
Background

Among the peritoneal dialysis (PD) complications, those microbial related or infectious peritonitis figures as the most frequent. Peritonitis (P) is recognized as one of the main causes of technique failure and HD transfer. It is associated with faster loss of residual renal function, greater peritoneal membrane damage (sclerosis) and consequently PD adequacy issues. Also, those with P have a lower quality of life and impose a higher healthcare expenditure(1). Early on this year, the ISPD recommended a new target for the overall peritonitis rate and the percentage of patients free of P per unit time(2). Our aim is to apply these new ISPD targets to our 7-year PD cohort.
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Methods

A retrospective, multicentric, and descriptive cohort study in patients with PD, belonging to the National Health System of the Dominican Republic. Conducted between January 1, 2016, and December 31, 2021. Sociodemographic data and disease characteristics were included. Quantitative variables are expressed as mean ± standard deviation, while qualitative variables were presented with absolute and relative frequencies. In addition, the incidence of peritonitis rate, HD transfer, deaths, and cure was analyzed. The Peritonitis was diagnosed according to the ISPD guidelines.

Results

A total of 4,575 PD patients were included, 57% men; the mean age was 49 + 19 years, 53% had Diabetes Mellitus (DM) diagnosis, and 65% had a basic educational level. Patients censored were 151 (11%). 575 peritonitis episodes were recorded, the median time to the 1st peritonitis event was 476 days, 81% episodes cured, 10% were transfer to HD 7.3% death, and 63 patients present more than 1 peritonitis episode. The overall peritonitis rate was 0.13/year, having 53% of positive cultures.

Conclusion

Our PD program showed a superior peritonitis rate than that recommended by the new ISPD 2022 guidelines. We found no difference between our HD transfer rate and that reported by other programs. We still need to improve our culture-negative peritonitis rates which are high (47%). As a result of our continuous quality improvement (CQI) program, home visit, and follow–up protocol explains the median time to the 1st peritonitis event, far beyond the year.

Funding

  • Commercial Support