Abstract
BackgroundColonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. However, no study has yet described the risk factors in play.MethodsThis was a retrospective multicentre study. The medical records of patients on continuous ambulatory peritoneal dialysis (CAPD) who underwent colonoscopy from January 2003 to December 2012 were analysed. We recorded demographic characteristics, colonoscopic factors, use of prophylactic antibiotics, and development of peritonitis. Colonoscopy-related peritonitis was defined as peritonitis developing within 1 week after colonoscopy. Demographic and clinical characteristics were compared between patients who did and those who did not develop peritonitis.ResultsDuring the study period, 236 patients on CAPD underwent colonoscopy, of whom 9 (3.8%) developed peritonitis. The rates of polypectomy/endoscopic mucosal resection were significantly higher in the peritonitis group than in the no peritonitis group (66.7 vs. 23.4%, p = 0.009). Prophylactic antibiotics were prescribed before colonoscopy in 65 patients; none developed peritonitis. No patient who developed peritonitis received prophylactic antibiotics (p = 0.067).ConclusionsAdvanced procedures including polypectomy or endoscopic mucosal resection increase colonoscopy-related peritonitis in patients on CAPD. Randomized controlled trials to investigate whether prophylactic antibiotics are needed to prevent peritonitis in all CAPD patients are warranted.
Highlights
Peritoneal dialysis (PD) is a major form of renal replacement
Several studies have reported the development of peritonitis after colonoscopy in patients on PD. [11, 12] Recently, the American Society of Gastrointestinal Endoscopy and the International Society for Peritoneal Dialysis recommended that prophylactic antibiotics be prescribed before colonoscopy for such patients [5, 13]
To the best of our knowledge, this is the first multicentre study to explore the risk factors for colonoscopy-related peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD); we included the largest number of patients evaluated on this subject to date
Summary
Peritoneal dialysis (PD) is a major form of renal replacement. Peritonitis is an important complication associated with technical failure and death, as well as an important quality measure, in patients on PD. [1,2,3,4] The International Society for Peritoneal Dialysis recommends an annual peritonitis rate of less than 0.5 episodes per year [5]. [1,2,3,4] The International Society for Peritoneal Dialysis recommends an annual peritonitis rate of less than 0.5 episodes per year [5]. Several studies have reported the development of peritonitis after colonoscopy in patients on PD. [11, 12] Recently, the American Society of Gastrointestinal Endoscopy and the International Society for Peritoneal Dialysis recommended that prophylactic antibiotics be prescribed before colonoscopy for such patients [5, 13]. One study found that the rate of peritonitis was 6.4% in PD patients undergoing. Colonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. No study has yet described the risk factors in play
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