Related Experiment Video
Updated: Jun 2, 2026
A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
Published on: July 20, 2022
Evolution of microbiological trends and treatment outcomes in peritoneal dialysis-related peritonitis
S-T Huang1, Y-W Chuang, C-H Cheng
1Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Background And Aim:
Peritoneal dialysis (PD)-related peritonitis is a major risk factor of technique failure and contributes to significant mortality in patients undergoing PD. The aim of this study was to examine the evolution of microbiological trends and treatment outcomes of PD-related peritonitis in our hospital over the past 26 years.
Methods:
A total of 630 patients entered our CAPD program from February 1984 to June 2010. Among them, 119 patients (18.9%) experienced 599 episodes of peritonitis. Microbiological trends, treatment responses, techniques and patient survival were analyzed.
Results:
The incidence rate of total peritonitis showed a steady decline from 1.08 episodes/patient-year in 1984 to 0.25 episode/ patient-year in 2009 (p < 0.001). A similar trend was found in gram-positive (p < 0.001) and gram-negative peritonitis (p = 0.015). In contrast, there was a trend toward an increased proportion of gram-negative peritonitis. This increase was not due to an increased rate of gram-negative peritonitis but to the more dramatic fall in gram-positive peritonitis. Treatment of peritonitis resulted in a complete cure in 78.0% of patients, while 16.7% of patients required catheter removal and 5.3% died. Gram-positive organisms were associated with a more favorable outcome compared to gram-negative pathogens as manifested by a higher cure rate (p = 0.023). The patient survival and technique survival were much improved after 2000 compared to that before 2000 (p < 0.0001).
Conclusion:
A remarkable improvement in the outcome of PD-related peritonitis has been achieved in the past 26 years in our hospital. To further decrease peritonitis rates, attention needs to be directed at reducing gram-negative peritonitis.
Insights
Peritoneal dialysis (PD) peritonitis rates declined significantly over 26 years. While outcomes improved, reducing gram-negative peritonitis is key for further success in PD patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Epidemiology
Background:
- Peritoneal dialysis (PD)-related peritonitis is a critical factor in technique failure and mortality for PD patients.
- Understanding microbiological trends and treatment outcomes is vital for improving PD patient care.
Purpose of the Study:
- To analyze the 26-year evolution of microbiological trends in PD-related peritonitis.
- To evaluate changes in treatment outcomes for PD-related peritonitis over time.
Main Methods:
- Retrospective analysis of 630 patients in a continuous ambulatory PD (CAPD) program from 1984 to 2010.
- Examination of 599 peritonitis episodes in 119 patients, focusing on microbiological data, treatment response, and survival rates.
Main Results:
- A significant decline in overall peritonitis incidence from 1.08 to 0.25 episodes/patient-year was observed.
- Gram-positive peritonitis decreased more sharply than gram-negative, leading to a higher proportion of gram-negative cases.
- Treatment achieved a 78% cure rate, with 16.7% requiring catheter removal and 5.3% mortality; gram-positive infections had better outcomes.
Conclusions:
- Significant improvements in PD-related peritonitis outcomes have been achieved over 26 years.
- Future efforts should focus on strategies to reduce gram-negative peritonitis to further enhance patient and technique survival.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:25Peritoneal Dialysis III: Nursing Management
01:25Urinary Tract Infection II: Pathophysiology
01:30Peritoneal Dialysis I: Introduction and Procedure
01:27Acute Pyelonephritis I: Introduction