Salvage of the peritoneal dialysis catheter in <i>Candida</i> peritonitis using amphotericin B catheter lock

Sluijs, Anita van Eck van der; Eekelschot, Kamal Zaj; Frakking, Florine N. J.; Haas, Pieter-Jan; Boer, Walther H.; Abrahams, Alferso C

doi:10.1177/0896860820923238

Cited by 5 publications

(2 citation statements)

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Section: Discussionmentioning

confidence: 99%

“…Examples are temporary discontinuation of PD without removing the catheter (peritoneal rest) combined with intravenous meropenem and meropenem intracatheter as lock (Mero-PerRest protocol) in case of enteric peritonitis and the treatment with amphotericin B catheter lock for salvage of the PD catheter in case of Candida peritonitis. 32,33 Catheter-related problems have been identified as an important cause of early technique failure in previous studies. 10,23 In this study, we identified leakage as another important cause of early technique failure.…”

Section: Discussionmentioning

confidence: 99%

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Technique failure in peritoneal dialysis: Modifiable causes and patient-specific risk factors

et al. 2022

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Background: Technique survival is a core outcome for peritoneal dialysis (PD), according to Standardized Outcomes in Nephrology-Peritoneal Dialysis. This study aimed to identify modifiable causes and risk factors of technique failure in a large Dutch cohort using standardised definitions. Methods: Patients who participated in the retrospective Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes cohort study and started PD between 2012 and 2016 were included and followed until 1 January 2017. The primary outcome was technique failure, defined as transfer to in-centre haemodialysis for ≥ 30 days or death. Death-censored technique failure was analysed as secondary outcome. Cox regression models and competing risk models were used to assess the association between potential risk factors and technique failure. Results: A total of 695 patients were included, of whom 318 experienced technique failure during follow-up. Technique failure rate in the first year was 29%, while the death-censored technique failure rate was 23%. Infections were the most common modifiable cause for technique failure, accounting for 20% of all causes during the entire follow-up. Leakage and catheter problems were important causes within the first 6 months of PD treatment (both accounting for 15%). APD use was associated with a lower risk of technique failure (hazard ratio 0.66, 95% confidence interval 0.53–0.83). Conclusion: Infections, leakage and catheter problems were important modifiable causes for technique failure. As the first-year death-censored technique failure rate remains high, future studies should focus on infection prevention and catheter access to improve technique survival.

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Section: Discussionmentioning

confidence: 99%