POS-725 DOES EARLY ONSET PERITONITIS ASSOCIATED WITH TECHNIQUE FAILURE AND ALL-CAUSE MORTALITY?

Abstract

Several studies have shown early peritonitis onset are associated with poor technique survival and increased long-term mortality. However, there was no consensus at this moment to define early versus late onset of peritonitis. Thus, we aimed to look for associated risk factors and outcomes such as technique failure and mortality in incident peritoneal dialysis (PD) patients following first episodes of peritonitis either early onset (EOP) versus late onset (LOP). This was observational retrospective single center study recruiting all incident peritoneal dialysis patients from 1st January 2017 to 31stDecember 2020 and followed up till 30 June 2021. First episode of peritonitis was recorded and divided into EOP and LOP. EOP defined as first onset peritonitis before 6 months after initiating PD while LOP was first onset peritonitis after 6 months of PD. Baseline demographic, clinical and laboratory data were collected. The outcomes were technique survival and all-cause mortality at the end of study period. SPSS Version 26.0 was used to analyze descriptive and categorical data. Total 228 peritonitis episodes were recorded during this study period; 101 cases were first episode of peritonitis. EOP occurred in 39 patients while 62 patients in LOP group. In EOP group, 19 (48.7%) were male, 20 (51.3%) female versus LOP group 38 (61.3%) were male, 24 (38.7%) were female, p=0.15. The mean age between EOP and LOP was 53.2(±12.3) and 54.2(±12.2), p=0.62. The mean duration from PD initiation to first onset peritonitis was 2.2±1.7 months in EOP group compared to 17.0±10.1 months in LOP group, p <0.01. There was no significant difference in demographic, clinical or laboratory data between the groups. There was higher incidence of culture negative in EOP group compared to LOP group, 16/39(41.0%) versus 19/62(30.6%), p=0.22 and gram-negative peritonitis in EOP group, 13/39(33.3%) versus 18/62 (29.0%), P=0.22. LOP group observed higher incidence of gram-positive peritonitis 19/62(30.6%) compared to EOP group 9/39(23.1%), p=0.22. In term outcome, higher rate of catheter salvage in EOP group 32/39 (82.1%) compared to LOP 35/62 (56.5%), p=0.07. There was also higher incidence transfer to hemodialysis (HD) amongst LOP group 17/62 (27.4%) versus EOP group 5/39 (12.8%), p=0.01. Till follow up period, there was no significant difference in Kaplan Meier survival curve in term technique failure and all-cause mortality between EOP and LOP. In our cohort patients, EOP was not significantly associated with technique failure and all-cause mortality as compared to LOP. Higher incidence of PD dropped out following peritonitis episodes in LOP group need further evaluation.