Kidney Week

Abstract: SA-PO462

Peritonitis Trends and Patient Outcomes in Peritoneal Dialysis from a Portuguese Center: Decades of Data Unlocked

Session Information

• Home Dialysis - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Dias, Joana Pereira, Unidade Local de Saude de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Joana Pereira Dias, MD

• Paes de Faria, Vitória Vaz da Rocha, Unidade Local de Saude de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Vitória Vaz da Rocha Paes de Faria, MD

• Bessa, Maria Beatriz, Unidade Local de Saude de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Maria Beatriz Bessa, MD

• Carmo, Rute, Unidade Local de Saude de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Rute Carmo, MD

• Lopes, Daniela, Unidade Local de Saude de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Daniela Lopes, MD

• Almeida, Clara, Unidade Local de Saude de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Clara Almeida, MD

• Gomes, Ana Marta, Unidade Local de Saude de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Ana Marta Gomes, MD

Background

Peritonitis is a common and severe complication of peritoneal dialysis (PD). This study aims to ascertain how the rate of peritonitis is evolving in our center, examine the factors that influence these cases and their outcomes, including the causative infectious agent, hospitalization and technique transference.

Methods

Between January 1, 1999, and December 31, 2023, 152 patients who started PD at our institution were included in the study. All PD-related peritonitis episodes were collected. Complicated peritonitis included recurrent, relapsing, repeating or refractory cases, guided by ISPD 2022 recommendations.

Results

The rate of peritonitis showed a steady decline over the study period, dropping from 0.7 episodes/patient in 1999 to 0.27 by the study's end. The majority of infections (76.3%) were managed on an outpatient basis and 72.4% progressed to healing. The most common causative agents were Gram-positive (GP) (57.9%), including coagulase-negative staphylococci (22.6%). GP infections were significantly linked to recent antibiotic exposure (p=0.017). Moreover, fungal peritonitis was found to be more common among male patients (p=0.032) and those with diabetes (p=0.046). Cases involving Gram-negative (GN) and fungal microorganisms exhibited worse outcomes, as depicted in Table 1.

Conclusion

Over the years, our center observed a notable decline in PD-related peritonitis, with most cases being effectively treated on an outpatient basis due to improved aseptic techniques, enhanced patient education, advancements in PD equipment, better antibiotic protocols, and regular monitoring and follow-up care. GP organisms remained the major cause of PD-related peritonitis, while GN and fungal peritonitis were associated with worse outcomes and a higher rate of PD failure, which is aligned with current literature. Understanding the trajectory of our center's experience provides invaluable insights for the development and continuous growth of our practices, enhancing patient outcomes and elevating the standards of care in PD.