Peritonitis in Children on Chronic Peritoneal Dialysis: The Experience of a Large National Pediatric Cohort

Abstract

Background: We performed this study to evaluate the incidence, risk factors, microbiology, treatment, and outcome of peritonitis in pediatric Peritoneal dialysis (PD) patients at a nationwide prospective study. Methodology: Patients younger than 18 years recruited in the BRAZPD II study from 2004 to 2011, who presented their first peritonitis episode, were included in the study. Results: We found 125 first episodes of peritonitis in 491 children PD patients (0.43 episodes/patient-year). Patients free of peritonitis episode constituted 75.6% in 1 year. Culture-negative episodes were very high (59.2%) and gram-positive (GP) bacteria were the most commonly found organisms (58.8%). First-generation cephalosporin was the initial choice to cover GP (40.5%) and aminoglycosides was the most prescribed antibiotics used for gram-negative agents (27.5%). Treatment failure was 26.4%. Technique failure (TF) occurred in 12.1% and peritonitis was the main cause (65.1%). Pseudomonas (p = 0.04) and negative cultures (p < 0.001) were identified as predictors of TF. Conclusion: Peritonitis remains a common complication of PD in children and negative cultures and pseudomonas had a negative impact on TF.

Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

“…The ratio of peritonitis in our study was lower than others because our time of follow-up was shorter than other studies. There was 27.3% patient with positive bacteria culture in our study, that similar to other study results [5,19].…”

“…Gadola L. et al [18] surveyed the rate of peritonitis in 222 PD patients following-up 6 years, the result showed 95 patients suffered 1 or more episodes of peritonitis (42.79%). In children, the ratio of peritonitis was 25.45% in Ponce's study with 7 years follow-up (125 rst episodes of peritonitis in 491 children PD patients) [19]. The ratio of peritonitis in our study was lower than others because our time of follow-up was shorter than other studies.…”

Overhydration and low serum prealbumin predict peritoneal dialysis-related peritonitis in continuous ambulatory peritoneal dialysis patients

“…The ratio of peritonitis in our study was lower than others because our time of follow-up was shorter than other studies. There was 27.3% patient with positive bacteria culture in our study, that similar to other study results [5,20].…”

Factors influencing occurrence of peritonitis in Saudi children on peritoneal dialysis

“…[11], where no variation was noted in the peritonitis rates among children. According to our study and their study, the peritonitis rate among Saudi children on PD appears higher than that reported in other countries [1,[4][5][6] where they met ISPD recommendations. There is a need for an urgent intervention program to reduce and prevent peritonitis in our center.…”