33 Years of Peritoneal Dialysis‐Associated Peritonitis: A Single‐Center Study in Japan

Abstract

Peritoneal dialysis-associated peritonitis (PD-associated peritonitis) could influence the outcome of PD patients, including technique survival. Although the use of the twin-bag system has decreased the incidence of peritonitis, the effects of biocompatible PD solutions are controversial. Additionally, since both infection-causing microorganisms and antimicrobial therapies have changed over time, the duration of treatment of peritonitis (the duration of peritonitis) seems to have changed. The study included 527 patients who received PD between January 1980 and December 2012 at a single center. We divided patients undergoing PD into three groups according to the type of PD system used, namely single-bag and conventional PD solutions (S+C group, N = 145), twin-bag and conventional PD solutions (T+C group, N = 171) and twin-bag and biocompatible PD solutions (T+B group, N = 211), and analyzed PD-associated peritonitis incidences. Incidences of PD-associated peritonitis (times per patient-months) and peritonitis-free time were 1/59.4, 1/70.6 and 1/103.1, and 52, 97, and 100 months for the S+C, T+C and T+B groups, respectively. The duration of peritonitis, has thus, become dramatically shorter in recent years. Streptococcus sp. were associated with shortest and fungi with longest durations of peritonitis. Staphylococcus sp. and Pseudomonas aeruginosa were predominant in the S+C group. The twin-bag system has made a greater contribution to reductions in PD-associated peritonitis than biocompatible PD solutions. Furthermore, changes in microorganisms, antimicrobial therapies, patient education and improved PD system devices have presumably affected the reduction in the duration of peritonitis.

A study on the information–motivation–behavioural skills model among Chinese adults with peritoneal dialysis

“…In Germany, 290 of 351 PD patients (82.6%) had episodes of peritonitis between 1979–2014 (Kitterer, Latus, Pöhlmann, Alscher, & Kimmel, ). A 33‐year, single‐centre study in Japan reported that peritonitis occurred in 195 of 527 patients (37%) (Nakao et al., ). Kim et al.…”

Effect of diabetes on incidence of peritoneal dialysis-associated peritonitis

“…This study was a post-hoc study of the previously reported cohort study [16]. In the previous cohort, we retrospectively reviewed the medical records of all 527 patients who initiated PD at our hospital between January 1980 and December 2012.…”

“…We recently reported a 33-year, single-center cohort study including 527 PD patients and 377 episodes of PD-associated peritonitis [16]. In that study, the prevalence of PD-associated peritonitis declined dramatically over the course of 33 years, despite the increasing populations of both diabetic and aging patients.…”

Risk factors for encapsulating peritoneal sclerosis: Analysis of a 36‐year experience in a University Hospital

“…'Recovery from peritonitis' was defined as being present if the above detailed criteria resolved. In addition, 'the duration of peritonitis' was defined as the period from diagnosis to recovery of peritonitis . Furthermore, 'total duration of peritonitis' was defined as the sum of 'the duration of peritonitis'.…”

“…14 Recently, we overviewed the 33 years' experience of peritoneal 377 peritonitis episodes in a university hospital, and both the incidences of peritonitis and the duration of peritonitis were dramatically reduced. 15 Hence, we suspected that decreased duration of peritonitis may be causing decreased incidence of EPS. This association can provide useable information regarding the importance of early detection and treatment for PD peritonitis.…”