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. 2023 Oct;38(10):3401-3406.
doi: 10.1007/s00467-023-05975-1. Epub 2023 Apr 25.

Training practices and peritonitis rates in children on maintenance peritoneal dialysis: results from the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative

Brandy Begin  1 , Troy Richardson  2 , Jennifer Ehrlich  3 , Bradley A Warady  4 , Alicia M Neu  5 ; Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative participating centers
Affiliations

Training practices and peritonitis rates in children on maintenance peritoneal dialysis: results from the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative

Brandy Begin et al. Pediatr Nephrol. 2023 Oct.

Abstract

Background: Comprehensive training of children on peritoneal dialysis (PD) and their caregivers is crucial to minimize peritonitis risk. Few studies have evaluated the impact of training on infection, so many published recommendations rely on expert opinion. This study uses data from the SCOPE collaborative to examine the impact of compliance with 4 components of PD training on the risk for peritonitis.

Methods: A retrospective cohort study of children enrolled in the SCOPE collaborative between 2011 and 2021 who received training prior to initiating PD. Compliance with 4 training components were assessed: performance of a home visit, 1:1 training, delaying training ≥ 10 days after PD catheter insertion and average individual training session length ≤ 3 h. Univariate and multivariable generalized linear mixed modeling were used to assess relationships between peritonitis ≤ 90 days after PD training and median days to peritonitis and compliance with each component as well as all-or-none compliance.

Results: Among 1450 trainings, 51.7% had median session length ≤ 3 h, 67.1% delayed training ≥ 10 days after catheter insertion, 74.3% had a home visit and 94.6% had 1:1 training. Only 333 trainings (23%) were compliant with all 4 training components. There was no statistically significant association between compliance with individual components, or all-or-none compliance and either the percentage of catheters with peritonitis ≤ 90 days after training end or median days to peritonitis.

Conclusion: No associations between 4 PD training components and risk for peritonitis were found. SCOPE requires monthly review of PD catheter practices which may have decreased the impact of training non-compliance. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: Children; Peritoneal dialysis; Peritonitis; Training.

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References

    1. United States Renal Data System (2022) 2022 USRDS annual data report: ESRD among children and adolescents. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda. https://usrds-adr.niddk.nih.gov/2022
    1. NAPRTCS (2011) 2011 Annual dialysis report. https://naprtcs.org/ . Accessed 5 March 2023
    1. Schmitt CP, Cano F, Neu A (2022) Peritoneal dialysis. In: Emma F, Goldstein S, Bagga A, Bates C, Shroff R (eds) Pediatric nephrology, 8th edn. Springer Nature Switzerland, Cham, pp 1806–1833
    1. Neu AM, Miller MR, Stuart J, Lawlor J, Richardson T, Martz K, Rosenberg C, Newland J, McAfee N, Begin B, Warady BA, SCOPE Collaborative Participants (2014) Design of the standardizing care to improve outcomes in pediatric end stage renal disease collaborative. Pediatr Nephrol 29:1477–1484. https://doi.org/10.1007/s00467-014-2891-7
    1. Neu AM, Richardson T, Lawlor J, Stuart J, Newland J, McAfee N, Warady BA, SCOPE Collaborative Participants (2016) Implementation of standardized follow-up care significantly reduces peritonitis in children on chronic peritoneal dialysis. Kidney Int 89:1346–1354. https://doi.org/10.1016/j.kint.2016.02.015

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