The importance of the Patient's training in chronic peritoneal dialysis and peritonitis

In a chronic disease, traineeship in the methodology to be used to treat oneself is a key part of success from the beginning and during long-term treatment. In chronic peritoneal dialysis (PD), peritonitis emphasizes, in a certain way, the result of the apprenticeship. We set out to evaluate the relationship between the number of PD training lessons and the frequency of peritonitis. According to the number of lessons, we established three groups: A, up to 8 lessons; B, 9-13 lessons; and C, 14 or more lessons. We evaluated peritonitis rates and micro-organisms, and for the three groups, we compared (Kaplan-Meier method) peritonitis-free survival (PFS) at 1 year of treatment, with significance set at (log rank) p < 0.05. The study enrolled 90 patients (mean age: 51.5 +/- 15.33 years; 37 men). Respectively, groups A, B, and C included 27, 46, and 17 patients with an at-risk duration of 1535, 2879, and 665 patient-months (mean: 56.9 +/- 44, 62.6 +/- 47, and 39.1 +/- 37.8 patient--months), of whom 35%, 37%, and 24% experienced no peritonitis, for peritonitis rates of 0.31, 0.37, and 0.47, with coagulase-negative Staphylococcus (CNS) peritonitis rates of 0.125, 0.12, and 0.235, and PFS rates of 76.9%, 80.4%, and 70.6%. The PFS was not significantly different between the groups (p > 0.05). During 1 year of treatment, all three groups experienced a satisfactory PFS. More frequent retraining should be considered in patients who needed more training lessons at the start of PD.