Peritonitis in children undergoing dialysis. 10 years experience

Area of Science:

• Nephrology
• Pediatric Nephrology

Background:

• Peritonitis is a significant complication in patients undergoing peritoneal dialysis.
• Understanding the risk factors and outcomes of peritonitis is crucial for patient management.

Purpose of the Study:

• To review the clinical aspects of peritonitis in patients treated with continuous ambulatory peritoneal dialysis (CAPD) and continuous cyclic peritoneal dialysis (CCPD).
• To compare the peritonitis rates between CAPD and CCPD.
• To identify common pathogens and treatment outcomes.

Main Methods:

• Retrospective review of 83 patients treated with CAPD or CCPD between May 1978 and April 1988.
• Analysis of peritonitis episodes, including duration of dialysis, time to first episode, causative organisms, and treatment outcomes.
• Comparison of peritonitis rates between CAPD and CCPD modalities.

Main Results:

• Peritonitis occurred in 50 patients, with a mean dialysis duration of 17.8 months, compared to 33 patients with no peritonitis and a mean duration of 10.4 months.
• The mean time to the first peritonitis episode was 7.1 months.
• The peritonitis rate was lower in CCPD (1 episode per 12.9 patient-months) than in CAPD (1 episode per 8.1 patient-months).
• Gram-positive organisms, particularly Staphylococcus aureus, predominated (70% of episodes).
• Catheter replacement was necessary in 26 of 48 cases due to infection.
• Sixty-nine percent of patients were cured with antibiotic therapy alone.
• The mortality rate associated with peritonitis was 1.2%.

Conclusions:

• Peritonitis incidence is linked to the duration of peritoneal dialysis.
• Continuous cyclic peritoneal dialysis is associated with a lower peritonitis rate compared to continuous ambulatory peritoneal dialysis.
• Despite complications, peritoneal dialysis remains a favored treatment modality for children.