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Peritonitis in children receiving continuous ambulatory peritoneal dialysis in northeast Thailand
Suwannee Wisanuyotin1, Piyawadee Lertchanaruengrith, Apichat Jiravuttipong
1Department of Pediatric, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. drsuwannee@yahoo.com
Insights
Peritonitis is common in children with end-stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis (CAPD) in Thailand. Longer dialysis duration and higher creatinine levels at catheter placement were linked to peritonitis.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Renal Replacement Therapy
Background:
- Peritonitis is a significant complication in children undergoing continuous ambulatory peritoneal dialysis (CAPD) for end-stage renal disease (ESRD).
- Understanding peritonitis rates and associated factors in pediatric CAPD patients is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To determine the incidence of peritonitis in pediatric CAPD patients in Khon Kaen, Thailand.
- To identify clinical differences between peritonitis and non-peritonitis groups in this population.
Main Methods:
- Retrospective review of medical records for ESRD children (<15 years) receiving CAPD between 1994-2007.
- Analysis of patient demographics, peritonitis episodes, causative organisms, and clinical presentations.
Main Results:
- The peritonitis rate was 1 episode per 8.52 patient-months.
- Cloudy effluent, abdominal pain, and fever were the most common symptoms.
- Staphylococcus aureus and Enterococcus species were the predominant pathogens; 42.55% of cultures were negative.
- Peritonitis and non-peritonitis groups differed significantly in dialysis duration and serum creatinine levels.
Conclusions:
- Peritonitis is frequent in pediatric ESRD patients on CAPD in Northeast Thailand, often caused by gram-positive bacteria.
- Dialysis duration and baseline serum creatinine levels are associated with the risk of developing PD peritonitis.
Objective:
To clarify the peritonitis rate and to characterize the differences between the peritonitis and non-peritonitis group in ESRD children using continuous ambulatory peritoneal dialysis (CAPD) in Khon Kaen, Thailand.
Material And Method:
The authors reviewed the medical records of ESRD children under 15 years old at the time of PD catheter placement, who received CAPD in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University between 1994 and 2007.
Results:
Eighteen male andfifteen female patients were identified Their mean age at the time of PD catheter placement was 11.48 +/- 3.12 years (range, 3.52-15.67). Twenty patients (11 male and 9female) were complicated with 47 episodes of peritonitis during 400.44 patient-months. The peritonitis rate was one episode every 8.52 patient-months. The three most frequent clinical presentations were cloudy effluent (78.72%), abdominal pain (76.60%) and fever (63.83%). Negative effluent culture was 42.55%. Staphylococcus aureus and Enterococcus species were the two most frequent causative organisms. The dialysis duration and serum creatinine level were significantly different between the peritonitis and non-peritonitis groups.
Conclusion:
Peritonitis frequently occurred in ESRD children treated by CAPD in Northeast Thailand, particularly from gram-positive organisms. The dialysis duration and serum creatinine level at the time of catheter placement were associated with PD peritonitis.
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