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Abstract: FR-PO476

Nationwide Standardized Peritonitis Reporting: Updated Results From the Optimizing the Prevention of Peritoneal Dialysis Associated Peritonitis in the United States (OPPUS) Study

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Al sahlawi, Muthana, King Faisal University, Al-Hasa, Eastern, Saudi Arabia
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Bansal, Shweta, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • Block, Geoffrey A., US Renal Care, Inc, Plano, Texas, United States
  • Masud, Tahsin, Emory University, Atlanta, Georgia, United States
  • Piraino, Beth M., University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Schreiber, Martin J., DaVita Inc, Denver, Colorado, United States
  • Srivatana, Vesh, Rogosin Institute, New York, New York, United States
  • Teitelbaum, Isaac, University of Colorado Denver School of Medicine, Aurora, Colorado, United States
  • Watnick, Suzanne, Northwest Kidney Centers, Seattle, Washington, United States
  • Garcia, Leslie, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Perl, Jeffrey, Saint Michael's Hospital, Toronto, Ontario, Canada
Background

Peritoneal Dialysis (PD) associated peritonitis is a common complication of PD and is the leading cause of transfer to hemodialysis in the US. No formal mechanism or surveillance system exists for nationwide peritonitis reporting. Our primary aim was to develop a uniform widescale peritonitis reporting mechanism and evaluate its implementation in the Optimizing Prevention of PD-associated Peritonitis in US (OPPUS) study.

Methods

Following literature review, stakeholder consultation, and ISPD guidelines review, a web-based peritonitis tracker tool (OPPUS-Link) was developed. Pilot sites for one-year data collection were selected based on geography and reported peritonitis rates, including 3 medium-large dialysis organizations. We provided formal training, central data review, and adjudication of all peritonitis episodes and outcomes. Data collection began in October 2020 and is ongoing.

Results

Initial data for 53 participating facilities with a median follow-up time of 31 patient-years includes 350 peritonitis episodes (rate of 0.24 episodes/year). Permanent transfer to HD, PD catheter removal, and hospitalization occurred in 14%, 15%, and 41% of episodes respectively, with 6% of episodes resulting in death. Only 1.5% of peritonitis episodes occurred following PD catheter insertion but prior to PD at home. Ongoing challenges include high prevalence of culture-negative peritonitis (22% of episodes) and high percentage of peritonitis acquired in hospital (15%).

Conclusion

Standardized, uniform peritonitis reporting is feasible, a first step in national PD-peritonitis surveillance, allowing for benchmarking, outbreak identification, and quality improvement initiative implementation. Further data validation is necessary and integrating routine peritonitis reporting in electronic health records with an overall goal of peritonitis reduction and improved outcomes for PD patients.

Funding

  • Other NIH Support