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. 2024 May 11;25(1):163.
doi: 10.1186/s12882-024-03594-y.

Peritoneal dialysis related peritonitis: insights from a long-term analysis of an Italian center

Luca Nardelli  1   2 , Antonio Scalamogna  3 , Federico Ponzano  3 , Anna Sikharulidze  3 , Federica Tripodi  3 , Simone Vettoretti  3 , Carlo Alfieri  3   4 , Giuseppe Castellano  3   4
Affiliations

Peritoneal dialysis related peritonitis: insights from a long-term analysis of an Italian center

Luca Nardelli et al. BMC Nephrol. .

Abstract

Background: Peritonitis is a common and severe complication of peritoneal dialysis (PD). For comparative analysis standardized definitions as well as measurements and outcomes are crucial. However, most PD-related peritonitis studies have been using heterogenous definitions and variable methods to measure outcomes. The ISPD 2022 guidelines have revised and clarified numerous definitions and proposed new peritonitis categories and outcomes.

Methods: Between 1st January 2009 and 31st May 2023, 267 patients who started PD at our institution were included in the study. All PD-related peritonitis episodes that occurred in our unit during the study period were collected. The new definitions and outcomes of ISPD 2022 recommendations were employed.

Results: The overall peritonitis rate was 0.25 episode/patient year. Patient cumulative probability of remaining peritonitis-free at one year was 84.2%. The medical cure and refractory peritonitis rates were equal to 70.3 and 22.4%, respectively. Culture-negative peritonitis accounted for 25.6% of all specimens. The rates of peritonitis associated death, hemodialysis transfer, catheter removal and hospitalization were 6.8%, 18.3%, 18.7% and 64.4%, respectively. Relapsing, repeat, recurrent and enteric peritonitis accounted for 7.8%, 6.8%, 4.1% and 2.7% of all episodes, respectively. Catheter insertion, catheter related and pre-PD peritonitis were 4.2, 2.1 and 0.5%.

Conclusions: The implementation of PD-related peritonitis reports using standardized definitions and outcome measurements is of paramount importance to enhance clinical practice and to allow comparative studies.

Keywords: Catheter; HD transfer; Hospitalization; Mortality; Peritoneal dialysis; Peritonitis.

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Conflict of interest statement

The authors declare no competing interests.

We have read and understood BMC Nephrology’s policy on disclosing conflicts of interest and declare that we have none.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curve of Peritonitis Free-survival. No = number; m = months
Fig. 2
Fig. 2
(A) causes of peritoneal dialysis discontinuation; (B) causes of hemodialysis transfer
See this image and copyright information in PMC

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