ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO983

Prevention of Pre-Training Peritonitis in Patients Non-Integrated to a Peritoneal Dialysis Program

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Alcantar Vallin, Maria de la luz, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Romero, Alexia, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Cervantes, Cynthia G., Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Medina, Ramon, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Chavez, Jonathan, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Rodríguez García, Francisco Gonzalo, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Calderon Garcia, Clementina Elizabeth, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Navarro Blackaller, Guillermo, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
Background

Around 70% of patients without Social Security who develop end stage chronic kidney disease (ESKD) whom choose peritoneal dialysis requiere urgent-start, after stabilization, integration to our CAPD program can take more than two months due to the lack of infrastructure and patient resources. During this time they receive intermittent PD every two weeks until training and integration but the uremic milieu and the poor nutritional status increase the risk of peritonitis events, associated with prolonged hospitalizations, technique failure and death in up to 87.5 %. Intraluminal peritoneal catheter antibiotic lock has been used in patients with recurrent peritonitis, but the usefulness in pre-training peritonitis prevention in this group of patients is unknown.

Methods

Randomized clinical trial, 1:1, blinded placebo controlled in patients with urgent start peritoneal dialysis (Fig 1); after receiving Intermittent peritoneal dialysis, prior to hospital discharge, an PD catheter lock was used with 3 ml of heparin/gentamicin solution (concentration 909U/3.6mg/ml) or 3ml of 1.5% dialyzing fluid Fortnightly during 6 months or until CAPD program integration. We evaluated the number of peritonitis and mechanical dysfunction.

Results

42 patients were analyzed (70% men), 22 received antibiotic lock, no difference in Mean age between groups (47.5y in the intervention vs 33y in placebo), diabetes (45% vs 20%), urea (209.5 vs 298 mg/dl) respectively, similar Hemoglobin levels (8 g/dl) in both groups. The integration time to CAPD was 76 days in control group and 104 days in the antibiotic group. The peritonitis rate was 0.2 in the intervention group vs 1.9 in the placebo group (p=0.49 CI 0.48-1). No microbial resistance was reported and no difference in adverse events between groups.

Conclusion

The application of PD catheter antibiotic lock with gentamicin its safe and can be considered for pre-training peritonitis prevention until CAPD program integration, however, larger studies are required.