A systematic review of peritoneal dialysis-related peritonitis rates over time from national or regional population-based registries and databases

Abstract

Peritoneal dialysis (PD)-related peritonitis is one of the top priorities for care and research among PD stakeholders. This study summarizes PD peritonitis rates from available population-based national or regional registries around the world, examining trends over time. This is a systematic review of PD peritonitis rates in patients treated with PD for kidney failure, from census-based national or provincial/statewide/provider registries or databases. MEDLINE (via PubMed) was searched from inception to August 2020, and inquiries made to national registry personnel using the International Comparisons section of the 2018 United States Renal Data System Annual Data Report as a contact list. Quantitative synthesis was done using weighted random-effects Poisson regression. Of 81 countries that reported utilization of PD, 19 did not have a traditional dialysis registry (governed by either professional societies or government entities), and only 33 monitored PD peritonitis rates correctly and accessibly. There is wide variation in PD peritonitis rates between countries, although the global average has been decreasing over time, from 0.600 episodes/patient-year in 1992 to 0.303 in 2019. Other sources of variability include the continent in which the country is nested and the size of its PD population. PD peritonitis, despite its importance for PD stakeholders, is under-monitored. While the global rate is decreasing over time, the presence and extent of this improvement varies from country to country. There is an opportunity for better monitoring, research into underachieving and overachieving nations and development of international clinical support networks.

Clinical outcomes and performance indicators of patients with kidney failure and acute kidney injuries in ASEAN countries

“…However, this finding was an association only, with uncertain causality, bearing in mind that PD practice and penetration was likely to be very different between continents. 91 Collectively, as a group, the peritonitis rates (0.18 to 0.40 episodes per patient-year) for ASEAN countries appeared to be similar to those studied in the Peritoneal Dialysis Outcomes and Practice Pattern Study (0.26 to 0.38 episodes per patientyear). 52 The results of HRQOL studies showed that higher-income countries (Brunei, Singapore and Malaysia) tend to show that PD patients have a better quality of life, consistent with trends in developed countries.…”

Peritoneal Dialysis for Potential Kidney Transplant Recipients: Pride or Prejudice?

“…In the 1980s, the introduction of peritoneal dialysis (PD) into clinical practice [14,15], raised the question of which RRT should have been preferred in potential KT recipients [16][17][18][19]. Main concerns regarding the routinary use of PD in this particular population were the presence of peritoneal scarring due to previous abdominal surgery, the risk of peri-operative peritonitis [20,21] or exit-site/tunnel infections [20,22], the higher susceptibility to post-transplant diabetes mellitus [23,24], the possible development of encapsulating peritoneal sclerosis [25,26], and the perceived increase in graft thrombosis [23,[27][28][29]] and acute rejection rates [16,30].…”

Peritoneal Dialysis Associated Peritonitis Rate – Validation of a Simplified Formula

“…La péritonite reste la complication la plus urgente et la plus sévère de la dialyse péritonéale (DP). Au cours des deux dernières décennies, les améliorations apportées à la technique et à la prise en charge des patients ont réduit la probabilité de péritonite à un niveau historiquement bas [1]. Malgré ces progrès, la péritonite représente encore jusqu'à 5 % des causes de décès en DP [2] et sa prévention est une priorité pour améliorer les résultats centrés sur le patient [3,4].…”

“…Malgré l'importance du taux de péritonite en DP, seule une minorité d'administrations sanitaires mesurent et déclarent les taux de péritonite [1]. Ceci est en grande partie dû aux difficultés rencontrées par les centres de DP pour calculer leur taux de péritonite, soit par mauvaise compréhension de la formule, soit par manque des données nécessaires.…”

“…Taux de péritonite en dialyse péritonéale : validation d'une formule de calcul simplifiée (Peritoneal Dialysis Associated Peritonitis Rate -Validation of a Simplified Formula) Mark R Marshall 1,2 , Gerald P Waters 3,4 , Christian Verger…”