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Abstract: SA-PO634

Peritonitis Impact on Technique Failure and Time to First Peritonitis Event in Peritoneal Dialysis: A Retrospective Multicenter Cohort Study in the National Health System of the Dominican Republic

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Hernandez-Ordonez, Sergio O., Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Campos, Erwin I., Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Polanco, Elianny S., Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Lara, Zulma, Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Aquey, Mercedes, Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Divino-Filho, Jose C., Karolinska Institutet Enheten for medicinska njursjukdomar, Huddinge, Stockholm, Sweden
  • Guzman Chavez, Janny, Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic
  • Cuevas Budhart, Miguel Angel, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
  • Ramos, Alfonso, Macrotech, Santo Domingo, Distrito Nacional, Dominican Republic

Group or Team Name

  • Macrotech.
Background

Peritonitis is a concern in peritoneal dialysis (PD) as it is a common complication that impacts outcomes and technical survival. It is a frequent cause of technique failure. The aim of this study is to estimate the impact of peritonitis on technique failure and determine the time to the presentation of the first peritonitis event.

Methods

A retrospective, multicenter, and descriptive cohort study was conducted on patients enrolled in the home PD program of the National Health System of the Dominican Republic. Peritonitis was diagnosed based on the ISPD guidelines. The analysis included incident PD patients enrolled between January 1st, 2016, and December 31st, 2022. Demographic data were collected and presented as mean ± SD for quantitative variables, while qualitative variables were reported as absolute and relative frequencies. A binary logistic regression was performed for the possible association between variables of interest using Odds Ratio, with a confidence interval of 95% and p value < 0.05. To assess survival, only peritonitis events were considered using Kaplan-Meier curves and the Log-Rank test.

Results

We studied 4,476 incident patients with a median follow-up of 693 days, with a range of 30 to 2,465 days. The mean age was 57 ± 15 years, and 58% of the patients were males. Among the patients, 393 (8.7%) experienced a peritonitis event, with 53 (1.1%) having two events, and 10 (0.22%) patients experiencing three or more events. Out of those who had peritonitis, 79% were cured, 12% transitioned to hemodialysis (HD), and 7.9% died. The median time to the first peritonitis events was 474 days (CI 431-517) The factors associated with the development of peritonitis were patients older than 65 years (OR: 1.94; 95%CI: 1.49-2.52: p<.001) and having been on therapy for more than a two-year period (OR: 2.86; 95%CI: 2.10-3.88).

Conclusion

in this analysis, factors such as older age and a longer duration of therapy were associated with an increased risk of developing peritonitis. The time at the first event is higher than reported in other studies. These highlight the importance of implementing preventive strategies and close monitoring in PD.

Funding

  • Commercial Support – Macrotech