Risk of Peritonitis among Disadvantaged CAPD Patients in Mexico

Garcia-Garcia, Guillermo; Tachiquín-Bautista, Noemi; Luquin-Arellano, Victor Hugo; Ibarra-Hernandez, Margarita; Aviles-Gomez, Raymundo; Briseño-Renteria, Gregorio; Cueto-Manzano, Alfonso M.

doi:10.1159/000096961

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…The dropout rate was 33% in the 26-month period, similar to rates observed in other studies 13,19,31,32 and accordingly, the main reason for dropout was cardiovascular death. Peritonitis continues to be a problem both related to dropout and mortality, corroborating with other studies in Latin America, 33 and represents a major target for dropoutreducing interventions. The high rate of negative cultures observed in this study could be at least in part responsible for the technique failure and should be a target for the development of more effective protocols.…”

Section: Discussionsupporting

confidence: 84%

The Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD): Characterization of the cohort

Fernandes

Bastos

Cassi³

et al. 2008

Kidney International

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The Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD) was launched in December 2004 aiming to collect data monthly and continuously from a representative cohort, allowing for a continuous snapshot of the peritoneal dialysis (PD) reality in the country. This is an observational study of PD patients comprising follow-up from December 2004 to February 2007 (mean follow-up of 13.6 months-ranging from 1 to 26 months) in 114 Brazilian centers. All centers report data through a central web-based database. After an initial baseline retrospective data collection, all patients are followed prospectively every month until they drop out from the PD program. Total number of patients recruited until February 2007 was 3226 (2094 incident patients). Mean age was 54+/-19 years (37% above 65 years old), with 55% females and 64% Caucasians. The more frequent causes of renal failure were diabetic nephropathy (34%), renal vascular disease associated with hypertension (26%), and glomerulopathies (13%). The most common comorbidities were hypertension (76%), diabetes (36%), and ischemic heart disease (23%). Automated PD (APD) was the modality utilized in 53%. The estimated overall peritonitis rate was 1 episode per 30 patient-months (most frequently due to Staphylococcus aureus). The total dropout rate was 33%, mainly due to deaths, whereas 20% of dropouts were due to renal transplant. The gross mortality was 17.6% and the main causes of mortality were cardiovascular diseases (40%) and infections (15%). The initial results of this first Brazilian PD registry provide a unique opportunity to develop future clinical studies addressing specific PD questions in the Brazilian reality and context.

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Section: Discussionsupporting

confidence: 84%

The Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD): Characterization of the cohort

Fernandes

Bastos

Cassi³

et al. 2008

Kidney International

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“…Although the climatic and socioeconomic conditions of the region can favor the occurrence of peritonitis, incidence similar to that in developed regions can be observed today, due most likely to improvements in PD expertise and incorporation of safer systems. In agreement with this concept, Garcia-Garcia et al (70), in Mexico, recently presented low peritonitis rates using the double-bag system in a high-risk population with poor living standards. With respect to microbiological issues, the high prevalence of oxacillin-resistant CoNS and the S. aureus etiology as well as the growing contribution of gram-negative bacilli are significant findings.…”

Section: Discussionmentioning

confidence: 71%

“…In agreement with this concept, Garcia–Garcia et al . (70), in Mexico, recently presented low peritonitis rates using the double-bag system in a high-risk population with poor living standards. With respect to microbiological issues, the high prevalence of oxacillin-resistant CoNS and the S. aureus etiology as well as the growing contribution of gram-negative bacilli are significant findings.…”

Section: Discussionmentioning

confidence: 99%

Peritonitis in Latin America

et al. 2007

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Peritoneal dialysis has a high acceptance rate in Latin America, thus the knowledge concerning complication patterns is of great relevance. This work reviews Latin American data on peritonitis, the most serious complication of peritoneal dialysis. The incidence of peritonitis has been reduced over time, concomitantly with the incorporation of safer exchange systems and the use of prophylactic measurements. Today, rates lower than 1 episode per 24 patient-months are commonly reported. Furthermore, changes in causative organisms have been observed, with predominance of Staphylococcus aureus up through the mid-1990s, as well as increases in coagulase-negative staphylococcus and participation of gram negatives. However, the prevalence of S. aureus is still high, due possibly to climatic conditions and the elevated prevalence of carriers. Resolution rate varies from 55% to 78%, transfer to hemodialysis from 10.9% to 15.4%, and death in 3% to 9.9% of cases. Outcome is worse in S. aureus episodes compared to those with coagulase-negative staphylococcus, despite the higher percentage of oxacillin-resistant strains among the former. In general, despite socioeconomic or climatic conditions, our results are similar to those in developed countries, perhaps as a consequence of technological improvements and/or center expertise.

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Risk of Peritonitis among Disadvantaged CAPD Patients in Mexico

Abstract: We conclude that switching from a standard to a double-bag system using electrolytically produced sodium hypochlorite disinfectant markedly decreased the peritonitis rate, even in a high-risk population like ours.

Cited by 2 publications

References 16 publications

The Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD): Characterization of the cohort

The Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD): Characterization of the cohort

Peritonitis in Latin America

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