DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20212334

Peritoneal dialysis associated-peritonitis: a preventable complication

Regina de Miguel-Ibañez, Carlos Alberto Ramirez-Ramirez, Marcos Daniel Sanchez-Gonzalez, Angel Cesar Ortiz-Bello

Abstract


Peritoneal dialysis is useful renal replacement therapy for patients with end-stage chronic kidney disease. Latin America has 30% of the world population in peritoneal dialysis and within these countries Mexico covers 73% of them. In our country, the Mexican institute of social security (IMSS by its Spanish acronym) serves more than half of the Mexican population that requires renal replacement therapy. In 2014 it represented 15% of total annual cost of the institution. Peritonitis in peritoneal dialysis is the main complication seen in this renal replacement therapy with morbidity and mortality from 2 to 6%. The epidemiology of peritonitis associated with peritoneal dialysis varies according to the continent, country and dialysis center. The rate of peritonitis per year of each center reflects their quality of care. The prevention, diagnosis and treatment of peritonitis impact in the quality of life of the patient, the success of renal replacement therapy, public health costs and associated mortality. This review addresses the epidemiology, diagnosis, treatment, and preventive measures of peritonitis, focused on the procedures for improving the standards of care.


Keywords


Peritoneal dialysis, Peritonitis, Risk factors, Quality improvement

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References


Andreoli MCC, Totoli C. Peritoneal dialysis. Rev Assoc Med Bras. 2020;66:s37-44.

Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int. 2016;36(5):481-508.

Prevention, diagnosis and treatment of chronic kidney disease. evidence and recommendations guide: clinical practice guide. Mexico; Cenetec: 2019.

Li PK, Chow KM, Van de Luijtgaarden MW, Johnson DW, Jager KJ, Mehrotra R, et al. Changes in the worldwide epidemiology of peritoneal dialysis. Nat Rev Nephrol. 2017;13(2):90-103.

Rosa-Diez G. Renal replacement therapy in Latin American end-stage renal disease. Clin Kidney J. 2014;7:431-6.

Piraino B, Bernardini J, Brown E, Figueiredo A, Johnson DW, Lye WC, et al. ISPD position statement on reducing the risks of peritoneal dialysis-related infections. Perit Dial Int. 2011;31(6):614-30.

Mehrotra R, Devuyst O, Davies SJ, Johnson DW. The Current state of peritoneal dialysis. J Am Soc Nephrol. 2016;27(11):3238-52.

Sipahioglu MH, Aybal A, Unal A, Tokgoz B, Oymak O, Utas C. Patient and technique survival and factors affecting mortality on peritoneal dialysis in Turkey: 12 years’ experience in a single center. Perit Dial Int. 2008;28(3):238-45.

Htay H, Cho Y, Pascoe EM, Darssan D, Nadeau-Fredette AC, Hawley C, et al. Center effects and peritoneal dialysis peritonitis outcomes: analysis of a national registry. Am J Kidney Dis. 2018;71(6):814-21.

Chen TW, Li SY, Chen JY, Yang WC. Training of peritoneal dialysis patients Taiwan’s experiences. Perit Dial Int. 2008;28(3):S72-5.

Cleper R, Davidovits M, Kovalski Y, Samsonov D, Amir J, Krause I. Peritonitis in a pediatric dialysis unit: local profile and implications. Isr Med Assoc J. 2010;12:348-52.

Méndez-Durán A, Ignorosa-Luna MH, Pérez-Aguilar G, Rivera-Rodríguez FJ, González-Izquierdo JJ, Dávila-Torres J. Estado actual de las terapias sustitutivas de la función renal en el Instituto Mexicano del Seguro Social. Rev Med Inst Mex Seguro Soc. 2016;54(5):588-93.

Fang W, Ni Z, Qian J. Key factors for a high-quality peritoneal dialysis program--the role of the PD team and continuous quality improvement. Perit Dial Int. 2014;34(2):S35-42.

Qamar M, Sheth H, Bender FH, Piraino B. Clinical outcomes in peritoneal dialysis: impact of continuous quality improvement initiatives. Adv Perit Dial. 2009; 25:76-9.

Cho Y, Johnson DW. Peritoneal dialysis-related peritonitis: towards improving evidence, practices, and outcomes. Am J Kidney Dis. 2014;64(2):278-89.

Paniagua R, Ramos A, Fabian R, Lagunas J, Amato D. Chronic Kid- ney Disease and Dialysis in Mexico. Perit Dial Int. 2007;27:405-9.

Azap OK, Timurkaynak F, Sezer S, Cagˇir U, Yapar G, Arslan H, et al. Value of automatized blood culture systems in the diagnosis of continuous ambulatory peritoneal dialysis peritonitis. Transplant Proc. 2006; 38:411-2.

Salzer WL. Peritoneal dialysis-related peritonitis: challenges and solutions. Int J Nephrol Renovasc Dis. 2018;11:173-86.

Rüger W, van Ittersum FJ, Comazzetto LF, Hoeks SE, ter Wee PM. Similar peritonitis outcome in CAPD and APD patients with dialysis modality continuation during peritonitis. Perit Dial Int. 2011;31(1):39-47.

de Moraes TP, Olandoski M, Caramori JC, Martin LC, Fernandes N, Divino- Filho JC, et al. Novel predictors of peritonitis-related outcomes in the BRAZPD cohort. Perit Dial Int 2014;34:179-87.

Strippoli GF, Tong A, Johnson D, Schena FP, Craig JC. Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients. Cochrane Database Syst Rev. 2004;4:CD004679.

Kumar KV, Mallikarjuna HM, Gokulnath, Jayanthi S. Fungal peritonitis in continuous ambulatory peritoneal dialysis: The impact of antifungal prophylaxis on patient and technique outcomes. Indian J Nephrol. 2014;24(5):297-301.

Bender FH, Bernardini J, Piraino B. Prevention of infectious complications in peritoneal dialysis: best demonstrated practices. Kidney Int. 2006;70(103): S44-54.

Chow KM, Szeto CC, Cheung KK, Leung CB, Wong SS, Law MC. Predictive value of dialysate cell counts in peritonitis complicating peritoneal dialysis. Clin J Am Soc Nephrol. 2006;1(4):768-73.

Nouwen J, Schouten J, Schneebergen P, Snijders S, Maaskant J, Koolen M, et al. Staphylococcus aureus carriage patterns and the risk of infections associated with continuous peritoneal dialysis. J Clin Microbiol. 2006;44(6):2233.

Whitty R, Bargman JM, Kiss A, Dresser L, Lui P. Residual kidney function and peritoneal dialysis-associated peritonitis treatment outcomes. Clin J Am Soc Nephrol. 2017;12(12):2016.

Iñigo M, Del P. Infecciones por bacilos Gram negativos no fermentadores: Pseudomona-saeruginosa, Acinetobacterspp. Y Stenotropho-monasmaltophilia. 2018;12(50):2931-40.

Borrajo M, Pérez C. Tuberculous peritonitis in peritoneal dialysis. Soc Esp Nefrología. 2009;29(2): 95-184.

Kocyigit I, Unal A, Karademir D. Improvement in culture-negative peritoneal dialysis-related peritonitis: a single center’s experience. Perit Dial Int. 2012; 32(4):476-8.

Cullis B, Goh BL, Briggs VR, Brown EA, Dor FJMF. Creating and maintaining optimal peritoneal dialysis access in the adult patient. Perit Dial Int. 2019;39(5): 414-36.

Sastre LA, Linares FB, Aguilera FA, Prieto VM. EL reentrenamiento programado reduce la tasa de peritonitis en diálisis peritoneal. Nefrología. 2020; 40(5):810-1.

Chu KH, Choy WY, Cheung CC, Fung KS, Tang HL, Lee W, et al. A prospective study of the efficacy of local application of gentamicin versus mupirocin in the prevention of peritoneal dialysis catheter-related infections. Perit Dial Int. 2008;28(5):505-8.

Szeto CC, Li PK, Johnson DW, Bernardini J, Dong J, Figueiredo AE, et al. ISPD catheter-related infection recommendations. Perit Dial Int. 2017;37(2):141-54.

Gadallah MF, Ramdeen G, Mignone J, Patel D, Mitchell L, Tatro S. Role of preoperative antibiotic prophylaxis in preventing postoperative peritonitis in newly placed peritoneal dialysis catheters. Am J KidneyDis. 2000;36(5):1014-9.