Background and Aims The incidence of peritonitis has markedly decreased in the last decades, nevertheless it remains one of the main causes of catheter removal and subsequent dialysis modality change. In the long-term severe peritonitis and relapses can lead to peritoneal membrane failure. Some bacteria can form biofilms in the peritoneal catheter lumen granting them resistance against antibiotics and thus being one of the causes for infection recurrences. To find a viable way to avoid or/and eradicate the bacterial biofilm in the peritoneal catheters given the importance of infections. Method We present the experience in our peritoneal dialysis unit in the coadjuvant treatment of peritoneal dialysis-associated peritonitis with peritoneal catheter locks in the past few years. We used two kinds of peritoneal catheter lock depending on the isolated germ and divided them in two groups. Group I for the gram-positive staphylococcus group and Group II for gram-negative germs, specifically pseudomona. We reported 12 cases from which 10 were the first episode of gram-positive staphylococcus (epidermidis and Aureus) peritonitis. For the treatment we locked the catheter with 350mg of daptomycin in 7ml of saline solution once a week without using the catheter for 12 hours. For the other 2 cases of pseudomona peritonitis we locked the catheter with taurolidine/urokinase during the exchange with icodextrin twice a week with a 12 hours dwell time until 9 locks were archived. Results We treated 12 patients (Table 1). Peritonitis was resolved without recurrences in 9 of 10 patients in group I. In one case were a Methicillin-resistant Staphylococcus aureus was involved there was no response to the treatment and the peritoneal catheter was removed. In Group II both patients resolved their peritoneal infection without recurrences. Conclusion In our study peritoneal catheter locking seems to avoid the biofilm and reduce the peritoneal infection recurrences.

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Background and Aims The coronavirus disease 2019 (COVID-19) pandemic, has required a rapid and drastic transformation of health systems worldwide, and consequently also of Spanish Nephrology Units, to respond to the critical situation. The adaptation and transformation of nephrology services during the COVID-19 pandemic in Spain was a urgent need. During this period is worth noting that outpatient nephrology consultations were carried out largely virtually. In conclusion, the pandemic has clearly impacted clinical activity in Spanish Nephrology departments including ours at Virgen de las Nieves University hospital (Granada), reducing elective activity. Method At the beginning of the pandemic, we quickly adapted by designing an outpatient healthcare model adapted to the situation. With a virtual model we established direct communication via online almost in "real time" between primary care and our Nephrology Service consultation, avoiding unnecessary travel of patients and relatives, risk exposures to interpersonal and reducing the cost and the public crowds in the hospital. Based on inter-consultation criteria adapted to the guidelines and consensus documents of different societies, we established a new intercommunication system between Primary Care Physicians and external nephrology consultations, to FILTER consultations that did not require unnecessary exposures and reducing the cost of healthcare and the waiting time among others. Between June 2020 and December 2021, we received 372 cases referred from Primary Care for a first virtual assessment in the high-resolution nephrology clinic, clinical recommendations were effectively issued regarding complementary tests, treatment … and the need to refer to our Nephrology outpatient clinic for study and follow-up or not. Results Of the 372 patients evaluated VIRTUALLY, 38 were referred by Acute Kidney Injury (AKI) of which 35 were discharged with follow-up by their Primary Care Physician, 37 patients were referred by eGFR <30 ml / min / 1.73m2 being discharged 29, 66 patients were referred by eGFR between 30-60 ml / min / 1.73m2, being discharged 51 , 15 had Albumin / creatinine ratio (ACR ) between 30-300 mg / gr discharging 100%, 22 cases were consulted for ultrasound renal abnormalities and 18 of them were discharged, 5 were referred for apparently non-urological hematuria, not requiring nephrological follow-up in any case, the reason for referral "other causes" had n = 102 of which the main reason was "loss of an appointment in consultation during the pandemic", nephrectomy, kidney transplants with decompensation, family history of hereditary kidney disease (PKD, Alport …) without follow up need in n=95 of cases In Spain the activity of presential care in outpatient Nephrology consultations was suspended in 47% of the services, carrying out activity through telephone calls in 98.9%, that is, in the majority of Spanish hospitals. In 16.5% of the centers, telemedicine was the only form of external clinical visits. In 57% of the centers, outpatient follow-up tests were stopped during the pandemic. Conclusion The actual COVID-19 pandemic has demonstrated that a transformation and adaptation plan based on the optimization of resources, the implementation of telemedicine and the reorganization of our healthcare activity is necessary. The activity of presential care in outpatient Nephrology consultations was suspended in 47% of the Spanish Nephrology services(1). Humanity has demonstrated once again that it is capable of overcoming adversity, readjusting to change. In our virtual consultation, we attended 372 cases of which 288 (66.6%) were discharged with recommendations to their Primary Care Physician. Avoiding costs, unnecessary exposure of patients, relatives and healthcare personnel, giving an almost "real time” response to the patient and avoiding unnecessary travels. A model of care in external consultations that has come to stay in the future.