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Persistent peritonitis in peritoneal dialysis: a comphrenesive review of recurrent, relapsing, refractory, and repeat
Aaron H Wang1, Kelsey Sawyer2, Ankur D Shah3,4
1Warren Alpert Medical School, Brown University, Providence, RI, USA.
Abstract:
Peritonitis is a major cause of morbidity and technique failure in patients receiving peritoneal dialysis. Complicated peritonitis that manifests as multiple or unresolving episodes is classified as refractory, recurrent, relapsing, or repeat peritonitis, and often possesses higher risk of technique failure and mortality as well as lower complete cure rates than primary or uncomplicated episodes. While these peritonitis subtypes affect a considerable portion of PD patients, details regarding their epidemiology, pathogenesis, diagnosis, clinical sequelae, and management have not yet been fully elucidated. Improved clinical awareness and understanding of complicated peritonitis subtypes is crucial to ensure optimal management for these patients; thus, we consolidate and report the pertinent findings of recent literature on these four entities.
Insights
Complicated peritonitis in peritoneal dialysis (PD) patients, including refractory, recurrent, relapsing, and repeat cases, leads to higher risks. Understanding these complex conditions is vital for better patient management and outcomes.
Area of Science:
- Nephrology
- Infectious Diseases
- Dialysis Medicine
Background:
- Peritonitis is a significant complication in peritoneal dialysis (PD).
- Complicated peritonitis encompasses refractory, recurrent, relapsing, and repeat episodes.
- These subtypes are associated with increased technique failure, mortality, and lower cure rates.
Purpose of the Study:
- To consolidate and report recent literature findings on complicated peritonitis subtypes in PD patients.
- To improve clinical awareness and understanding of these specific peritonitis classifications.
- To guide optimal management strategies for PD patients experiencing complicated peritonitis.
Main Methods:
- Systematic review of recent literature on refractory, recurrent, relapsing, and repeat peritonitis.
- Consolidation of epidemiological, pathogenetic, diagnostic, and clinical data.
- Analysis of management strategies and outcomes reported in the literature.
Main Results:
- Complicated peritonitis subtypes present distinct challenges in PD.
- These conditions are linked to poorer patient outcomes compared to uncomplicated peritonitis.
- Current literature provides insights into the epidemiology, pathogenesis, and management of these subtypes.
Conclusions:
- Enhanced understanding of complicated peritonitis subtypes is crucial for PD patient care.
- Further research is needed to fully elucidate the nuances of these conditions.
- Optimized management protocols can improve outcomes for PD patients with complicated peritonitis.
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