Time until treatment initiation is associated with catheter survival in peritoneal dialysis-related peritonitis

Rikako Oki,Ryo Matsuura,Haruki Kume,Shiho Tsuji,Yohei Komaru,Yoshifumi Hamasaki,Kent Doi,Daisuke Yamada,Yoshihisa Miyamoto,Masaomi Nangaku

doi:10.1038/s41598-021-86071-y

Rikako Oki, Ryo Matsuura + Show 8 more

Open Access

https://doi.org/10.1038/s41598-021-86071-y

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Journal: Scientific Reports	Publication Date: Mar 22, 2021
Citations: 6	License type: open-access

Affiliation: University of Tokyo Hospital

Abstract

For peritonitis, a serious complication of peritoneal dialysis (PD), we investigated the relation between duration from the sign (PD effluent abnormalities) to treatment with appropriate antibiotics (ST time) and catheter removal. For 62 PD hospital patients, data of PD-related peritonitis (n = 109) were collected retrospectively. We examined ST time and PD catheter removal times using univariate and multivariate analyses. The catheter removal rate in the delayed ST time group (≥ 24 h) was higher than that in early ST time group (< 24 h) (38 vs. 16%, p = 0.02). Concomitant tunnel infection and delayed ST time were associated with catheter removal (OR [95% CI] 32.3 [3.15–329] and 3.52 [1.11–11.1]). Rates of catheter removal and re-development of peritonitis within 1 month after starting treatment were higher in the delayed ST time group (p = 0.02). PD duration at peritonitis and the first peritonitis episode were associated with delayed ST time (1.02 [1.00–1.04] and 3.42 [1.09–10.7]). Significant association was found between PD catheter removal and the start of treatment more than 24 h after appearance of abnormal effluent. Education for patients about prompt visitation at the onset of peritonitis with long PD duration might improve outcomes.

Highlights

A serious complication of peritoneal dialysis (PD), we investigated the relation between duration from the sign (PD effluent abnormalities) to treatment with appropriate antibiotics (ST time) and catheter removal
Peritoneal dialysis (PD) is described as an effective treatment modality for patients with end-stage renal disease, peritonitis remains a major complication of PD, which might result in discontinuation of P D1
After exclusion of 19 peritonitis cases for which PD catheter removal was decided based on the type of causative organism or for which PD catheter survival could not be followed-up, 109 peritonitis cases of 62 patients were examined as study subjects (Fig. 1)

Summary

Introduction

A serious complication of peritoneal dialysis (PD), we investigated the relation between duration from the sign (PD effluent abnormalities) to treatment with appropriate antibiotics (ST time) and catheter removal. Rates of catheter removal and re-development of peritonitis within 1 month after starting treatment were higher in the delayed ST time group (p = 0.02). Significant association was found between PD catheter removal and the start of treatment more than 24 h after appearance of abnormal effluent. Only 4% of patients after PD catheter removal were able to have re-insertion and continue long-term PD therapy[4]. This study was conducted to investigate the role of prompt treatment for PD-related peritonitis by examining the relation between the time from awareness of abnormalities of effluent to the initiation of treatment and Scientific Reports | (2021) 11:6547. We examined factors related to the delay of starting appropriate treatment for PD-related peritonitis

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Conclusion