Integrative Review on Risk Factors for Peritoneal Dialysis Related Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

Background: Chronic renal disease population has been increasing tremendously in the past decade. Over time, this population leads to end stage renal failure and require dialysis. Over 90% of dialysis population are on continuous ambulatory peritoneal dialysis in Hong Kong. Peritonitis remains the most serious and frequent complication for thecontinuous ambulatory peritoneal dialysis population. Identifying the risk factors for peritonitis can provide insight for healthcare team to design specific strategies to minimize this complication. Objective: To identify the risk factors associated with peritoneal dialysis related peritonitis in patients with continuous ambulatory peritoneal dialysis. Methods: Strategic search of literature was done in January 2016 through OVID SP database, including Medline, Embase and PsyInfo using the keywords “continuous ambulatory peritoneal dialysis”, “peritonitis” and “risk factor*”. The search was restricted to English sources. Two reviewers assess the selected studies quality with assessment tools. The characteristics and results from each study were summarized. Results: Fifteen studies met all criteria and 16 risk factors associated with continuous ambulatory peritoneal dialysis related peritonitis were identified. All these factors were further categorized into demographic related factors, clinical-related factors, system-related factors and modifiable factors. Conclusion: Although controversy exists in validating these risk factors, we can still cautiously use the identified risk factors to identify a high risk group, develop a tailored-made training program for them on continuous ambulatory peritoneal dialysis and evaluate the effectiveness of the training program for minimizing dialysis related peritonitis in patients with continuous ambulatory peritoneal dialysis.