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Peritonitis in the extended-care facility.

L K Troidle1, N Gorban-Brennan, A S Kliger

  • 1Renal Research Institute, New Haven, Connecticut, USA.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 29, 2000
PubMed
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Patients on continuous peritoneal dialysis (CPD) in extended-care facilities (ECFs) experience lower peritonitis rates than community patients. The study found differences in causative organisms and successful treatment outcomes within ECFs.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Geriatrics

Background:

  • Many end-stage renal disease (ESRD) patients require extended-care facility (ECF) admission.
  • Limited data exist on peritonitis development in continuous peritoneal dialysis (CPD) patients within ECFs.

Purpose of the Study:

  • To investigate the incidence, characteristics, and outcomes of peritonitis among CPD patients residing in ECFs.
  • To compare peritonitis rates and causative organisms in ECFs versus community settings.

Main Methods:

  • Retrospective chart review of 77 CPD patients in ECFs from November 1993 to August 1997.
  • Analysis of peritonitis episodes, patient demographics, ECF length of stay, and treatment outcomes.

Main Results:

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  • An overall peritonitis rate of 1 episode per 19.8 patient-months was observed in ECFs, lower than the community rate (1:10.0 patient-months).
  • African-American patients and those with longer ECF stays showed higher peritonitis incidence.
  • Gram-positive peritonitis rates were lower, while culture-negative rates were higher in ECFs compared to community settings.

Conclusions:

  • Peritonitis occurs less frequently in ECFs compared to the community, with a distinct microbial spectrum.
  • Continuous PD therapy can often be continued after peritonitis episodes in ECFs, with a high success rate (76%).