Predictor factors of peritoneal dialysis-related peritonitis

Peritonitis remains a major complication of peritoneal dialysis (PD).

Evaluate peritonitis incidence, etiology and outcome in cronic PD patients.

A retrospective cohort study was carried out on 330 patients (mean age of 53 ± 19 years) who had been treated by PD in a dialysis center in Aracaju/SE, Brazil between January 1st, 2003 and December 31th, 2007. Data of patients with and without peritonitis were compared using Student's t-test, chi-squared statistic and multiple logistic regression.

There were 213 peritonitis among 141 patients (1.51 episode/patient) resulting in a rate of 28.44 patient/episode/ month (0.42 patient/episode/year). Staphylococcus aureus was the most frequent micro-organism isolated (27.8%), followed by Escherichia coli (13.4%) and 32.5% were culture-negative peritonitis. A greater risk of peritonitis was identified at the patients with hypoalbuminemia [relative risk (RR) = 2.0; 95% confidence interval (CI) = 1.21 - 3.43; p < 0,01], < 4 school years (RR = 2.15; CI = 1.09 - 4.24; p = 0.03) and catheter's exit site infection (RR = 2.63; IC = 1.57 - 4.41; p < 0.01). There were no significant difference among gender, age, family income, diabetes mellitus, type of dialysis treatment, type of catheter and its surgical implant.

Hypoalbuminemia, low schooling and catheter's exit site infection were associated with greater risk to peritonitis. Although peritonitis rate follow international pattern, prophylactic strategies are recommended.