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Summary

Automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) show comparable peritonitis rates. APD may reduce Gram-positive peritonitis risk but increases Gram-negative peritonitis risk.

Keywords:
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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Peritoneal Dialysis

Background:

  • Conflicting evidence exists regarding peritonitis rates between continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD).
  • Understanding the comparative risks of PD-associated peritonitis is crucial for patient management.

Purpose of the Study:

  • To clarify the relationship between peritoneal dialysis (PD) modality (APD vs. CAPD) and the risk of developing PD-associated peritonitis.
  • To analyze the microbiology and clinical outcomes of peritonitis in relation to PD modality.

Main Methods:

  • A registry-based cohort study of 6959 incident Australian PD patients from 2003 to 2011.
  • Analysis of PD modality (APD vs. CAPD) and its association with peritonitis risk, microbiology, and outcomes.
  • Median follow-up of 1.9 years.

Main Results:

  • No significant difference in the overall time to first peritonitis episode between APD and CAPD (aHR 0.98).
  • APD associated with lower rates of culture-negative peritonitis (IRR 0.81) and higher rates of Gram-negative peritonitis (IRR 1.28).
  • Borderline significant reduction in Gram-positive peritonitis with APD (HR 0.90).

Conclusions:

  • PD modality (APD vs. CAPD) is not associated with an increased likelihood of peritonitis.
  • APD demonstrates a trend towards reduced Gram-positive peritonitis but increased Gram-negative peritonitis.
  • Overall peritonitis outcomes are comparable between APD and CAPD modalities.