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Peritoneal dialysis-associated peritonitis: clinical features and predictors of outcome.

Research paper by Diamantis P DP Kofteridis, Antonios A Valachis, Kostas K Perakis, Sofia S Maraki, Eugenios E Daphnis, George G Samonis

Indexed on: 21 Nov '09Published on: 21 Nov '09Published in: International Journal of Infectious Diseases



Abstract

The objective of this study was to identify the epidemiological, clinical, and microbiological factors affecting the outcome of peritoneal dialysis (PD)-associated peritonitis.All patients with PD-associated peritonitis, cared for at the University Hospital of Heraklion from 1990 to 2007, were retrospectively studied.A total of 247 episodes of PD-associated peritonitis occurring in 82 patients were evaluated. The median age of patients was 68 years (range 10-92 years); 51 (62%) were males. There were 104 episodes (42%) of Gram-positive peritonitis, 46 (19%) of Gram-negative peritonitis, 13 (5%) of polymicrobial peritonitis, and 11 (4%) of fungal peritonitis. There were 64 (26%) complicated episodes. The latter included 22 (8.9%) relapses, 13 (5.3%) repeated episodes, 18 (7.3%) catheter removals, and 11 (4.5%) deaths. In multivariate analysis, the presence of a purulent exit-site infection (p<0.001), peritoneal dialysis effluent cell count >100 x 10(6)/l for more than 5 days (p<0.001), use of antimicrobials during the preceding 3 months (p<0.05), and low serum total protein level on admission (p<0.05) were independent predictors of a complicated course.Exit-site infection, more than 5 days with a peritoneal dialysis effluent cell count >100 x 10(6)/l, prior use of antimicrobials, and low serum total protein level are potential predictors of complicated PD-associated peritonitis and may distinguish high-risk cases.