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Assessment of potential peritonitis risk factors in pediatric patients receiving maintenance peritoneal dialysis

Heather L Wasik1, Mahima Keswani2, Raj Munshi3

  • 1Division of Pediatric Nephrology, SUNY Upstate Medical University, Physicians' Office Building 805, 725 Irving Avenue, Syracuse, NY, 13210, USA. wasikh@upstate.edu.

Pediatric Nephrology (Berlin, Germany)
|July 8, 2023
PubMed

Insights

Peritonitis risk in pediatric peritoneal dialysis (PD) patients is not significantly affected by catheter insertion technique or prophylactic antibiotics. Gastrostomy timing may influence risk, warranting further investigation for evidence-based prevention strategies.

Area of Science:

  • Pediatric Nephrology
  • Peritoneal Dialysis
  • Infectious Disease Prevention

Background:

  • International guidelines for peritonitis prevention in peritoneal dialysis (PD) often lack strong evidence.
  • This study addresses the need for evidence-based recommendations for pediatric PD patients.

Purpose of the Study:

  • To evaluate the impact of PD catheter insertion technique on peritonitis risk.
  • To assess the influence of gastrostomy placement timing on peritonitis risk.
  • To determine the effect of prophylactic antibiotics on peritonitis risk in pediatric PD patients.

Main Methods:

  • Retrospective cohort study of pediatric patients on maintenance PD (2011-2022).
  • Data analyzed included laparoscopic vs. open catheter insertion, gastrostomy placement timing, and prophylactic antibiotic use.
  • Multivariable generalized linear mixed modeling was used to assess peritonitis risk.

Main Results:

  • PD catheter insertion technique showed no significant association with peritonitis risk.
  • Gastrostomy placement after PD catheter insertion was linked to higher peritonitis rates, though not statistically significant.
  • Prophylactic antibiotic use did not demonstrate a significant association with reduced peritonitis risk.

Conclusions:

  • PD catheter insertion technique does not significantly impact peritonitis risk in pediatric patients.
  • Gastrostomy placement timing may influence peritonitis risk, requiring further research.
  • The role of prophylactic antibiotics in preventing peritonitis needs additional investigation.
Abstract

Keywords:
ChildrenPeritoneal dialysisPeritonitis

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