Variation in Peritoneal Dialysis-Related Peritonitis Outcomes in the Peritoneal Dialysis Outcomes and Practice...

Area of Science:

• Nephrology
• Infectious Diseases
• Epidemiology

Background:

• Peritoneal dialysis (PD)-associated peritonitis is a major complication.
• Understanding factors influencing cure rates is crucial for patient management.

Purpose of the Study:

• To determine the likelihood of cure after a peritonitis episode in PD patients.
• To explore associations between cure and patient, peritonitis, and treatment characteristics.

Main Methods:

• Prospective observational cohort study involving 1,631 peritonitis episodes across 126 facilities globally.
• Mixed-effects logistic models were used to analyze cure rates, defined as absence of death, transfer to hemodialysis, catheter removal, relapse, or recurrent peritonitis within 50 days.

Main Results:

• An overall cure rate of 65% was observed.
• Lower cure odds were associated with Gram-negative, polymicrobial, and fungal peritonitis compared to Gram-positive.
• Higher cure odds were linked to automated PD, facility icodextrin use, empirical aminoglycoside use, and ciprofloxacin for Gram-negative infections.

Conclusions:

• Peritonitis cure rates in PD patients are influenced by infecting organisms and treatment strategies.
• Organism-specific treatment and modifiable practices like icodextrin use and antibiotic selection warrant further investigation to optimize PD peritonitis outcomes.