Kidney Week

Abstract: FR-PO1107

Clinical Characteristics, Pain Trajectories, and Outcomes in Patients with Peritoneal Dialysis-Related Peritonitis: A Multicenter Retrospective Study

Session Information

• Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Author

• Xu, Tao, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

Tao Xu, MD, PhD

Background

Peritoneal dialysis-related peritonitis (PDRP) is a common complication of PD that could lead to inadequate dialysis, technical failure and even death. The clinical characteristics and outcome of Gram-positive, Gram-negative and culture-negative subtypes remain unclear. However, in which direct us to formulate optimal management and judge prognosis based on three subtypes.

Methods

A multicenter retrospective study was conducted on 156 hospitalized PDRP patients from three centers between January 2020 and June 2025. Demographic, clinical laboratory, and treatment data were collected and analyzed.

Results

During the early phase of PDRP, patients with Gram negative infections presented with more severe inflammation compare to Gram-negative and culture-negative infections : higher peritoneal dialysate white cell counts(WCC 1st day 4177 vs. 1656 vs. 983×10⁶/l,P＜0.05), elevated C-reaction protein(142.4 vs. 95.1 vs. 77.1mg/L,P＜0.05) and procalcitonin(8.9 vs. 1.7 vs. 1.2ng/mL,P＜0.05), altered iron metabolism (increased serum ferritin: 425 vs. 388 vs. 223ng/mL and decreased serum iron: 4.6 vs. 7.7 vs. 6.2ng/mL,P＜0.05), and consistently higher abdominal pain scores from 2^nd to 14^th day (4.5 vs. 3.8 vs. 4.0 to 0.9 vs. 0.4 vs. 0.4,P＜0.05). Despite these differences, mortality did not differ significantly among the three groups. However, the treatment failure rate (catheter removal or death) was significantly higher in the Gram negative group (22.7% vs. 10.9% vs. 0%,P＜0.05). In multivariable analysis, hypoalbuminemia was the only factor independently associated with mortality, whereas Gram negative infection, elevated CRP, and hypoalbuminemia were independently associated with treatment failure.

Conclusion

Gram negative infections are associated with more severe inflammation, worse pain, and higher treatment failure. Although mortality was similar across groups, treatment failure was linked to infection type, inflammation, and nutritional status.