Abstract
BACKGROUND: Hypotension associated with peritoneal dialysis (PD)-related peritonitis as a presenting feature is not uncommon. However, the clinical courses following hypotension may vary in range and severity. We performed a retrospective study to evaluate the characteristics and in-hospital outcomes of hypotension at presentation of PD-related peritonitis in chronic PD patients.METHODS: Incident patients receiving chronic PD in three PD units between January 1998 and December 2009 were evaluated, PD patients with peritonitis indicating hospitalization and presenting with or without hypotension (Groups A and B, respectively) were included for study.RESULTS: In Group A (n=50), there were 46 (92%) peritonitis episodes associated with PD-related peritonitis, 3 (6%) due to mesenteric ischemia, and 1 (2%) following ligation of esophageal varices. The in-hospital mortality rate was 26% (10 PD-related peritonitis and 3 mesenteric ischemia), and 21 (42%) had transferred to hemodialysis. In Group B (n=90), there were 90 (100% ) peritonitis episodes associated with PD-related peritonitis. The in-hospital mortality rate was 3% (3 PD-related peritonitis) and 22 (24%) had transferred to hemodialysis. Multivariate logistic regression analysis in 136 patients with PD-related peritonitis indicating hospitalization showed that hypotension at presentation (OR 3.26, 95% CI 1.10-4.07), hospitalization duration ≥ 7 days (OR 6.67, 95% CI 1.44-8.88), serum alhumin (OR 0.39, 95% CI 0.15-0.91, per g/dL) and residual creatinine clearance (OR 0.91, 95% CI 0.84-0.98, per L/week/1.73 m^2) were significant predictors for in-hospital drop-out from PD.CONCLUSION: This study demonstrated that hypotension as a presenting feature of PD-related peritonitis is associate d with high in-hospital mortality and drop-out rate.
Published Version
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