Peritoneal Dialysis - State-of-the-Art 2012
Editor(s): Ronco, C. (Vicenza)Rosner, M.H. (Charlottesville, VA)
Crepaldi, C. (Vicenza)
Peritonitis and Other Clinical Outcomes
Prognostic Factors for Peritonitis Outcomevan Esch S. · Krediet R.T. · Struijk D.G.Division of Nephrology, Academic Medical Centre, University Hospital and Dianet, Amsterdam, The Netherlands
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Article / Publication Details
Published online: May 25, 2012
Cover Date: 2012
Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1
ISBN: 978-3-318-02162-2 (Print)
eISBN: 978-3-318-02163-9 (Online)
Abstract
Despite advances in treatment and prevention, peritonitis remains a major problem in peritoneal dialysis (PD) patients with often technique failure as a consequence. The last decades the focus of PD peritonitis has changed from lowering peritonitis incidence to improvement of peritonitis outcome. Prognostic factors for peritonitis outcome can influence decision making during the treatment of peritonitis, for example to take out the PD catheter early in the time course of peritonitis and prevent further damage to the peritoneal membrane. In this paper, we give a review of the literature about prognostic factors for peritonitis outcome. In most studies, age, gender, diabetes, time on PD, a precursor of calcitonin:procalcitonin, IL-6 and albumin did not show a significant effect on peritonitis outcome. The following factors have been associated with poor outcome of peritonitis: Gram-negative organisms, Mycobacterium species, fungal peritonitis, polymicrobial peritonitis, concurrent exit site or tunnel infection, Caucasian race, low residual GFR, persistently elevated peritoneal dialysate white cell count, CRP, and low levels of slCAM-1 and hyaluronan at the end of peritonitis treatment. In fungal peritonitis, abdominal pain, bowel obstruction, the catheter remaining in situ and Candidaparapsilosis are factors associated with higher mortality rate and a greater risk of technique failure. Recent antibiotic therapy and peritonitis are associated with poor treatment response in culture-negative peritonitis. Recurrent peritonitis episodes have a poor therapeutic response and high mortality and have a worse prognosis than relapsing ones. Older age, long PD duration and continuous elevated serum CRP levels are predictors of adverse outcomes in PD patients after peritonitis-related catheter removal. Peritonitis remains a serious complication of PD with marked morbidity. It is a common cause of technique failure. The rate of PD-related peritonitis has decreased over the last decades due to advances in treatment and prevention. Nowadays, the focus moved from lowering peritonitis incidence towards improving peritonitis outcome. It is useful to have prognostic factors for peritonitis outcome, because they can influence decision-making during the treatment of peritonitis, for example to take out the PD catheter early in the time course of peritonitis and prevent further damage to the peritoneal membrane. In the last decades, many publications appeared about prognostic factors for peritonitis outcome. This article summarizes those prognostic factors, based on an extensive review of the literature.
© 2012 S. Karger AG, Basel
References
-
Krishnan M, Thodis E, Ikonomopoulos D: , et al Predictors of outcome following bacterial peritonitis in peritoneal dialysis. Perit Dial Int 2002;22:573-581
-
Szeto CC, Wong TY-H, Chow KM, Leung CB, Li PK-T: The clinical course of culture-negative peritonitis complicating peritoneal dialysis. Am J Kid Dis 2003;42:567-574
-
Yang CY, Chen TW, Lin YP: , et al Determinants of catheter loss following continuous ambulatory peritoneal dialysis peritonitis. Perit Dial Int 2008;28:361-370
-
Perez Fontan M, Rodriguez-Carmona A, Garcia-Naveiro R, Rosales M, Villaverde P, Valdes F: Peritonitis-related mortality in patients undergoing chronic peritoneal dialysis. Perit Dial Int 2005;25:274-284
-
Golper TA, Brier ME, Bunke M: , et al Risk factors for peritonitis in longterm peritoneal dialysis: the Network 9 peritonitis and catheter survival studies. Am J Kid Dis 1996;28:428-436
-
Chow KM, Szeto CC, Cheung KK-T: , et al Predictive value of dialysate cell counts in peritonitis complicating peritoneal dialysis. Clin J Am Soc Nephrol 2006;1:768-773
-
Troidle L, Gorban-Brennan N, Kliger AS, Finkelstein FO: Effect of duration of chronic peritoneal dialysis therapy on the development of peritonitis. Perit Dial Int 1999;19:376-379
-
Elsurer R, Afsar B, Sezer S, Ozdemir FN: Peritoneal cells at admission: do they have prognostic significance in peritonitis?. Ren Fail 2010;32:335-342
-
Zalunardo NY, Rose CL, Ma IWY, Altmann P: Higher serum C-reactive protein predicts short and long-term outcomes in peritoneal dialysis-associated peritonitis. Kidney Int 2007;71:687-692
-
Wang AYM, Yu AWY, Li PKT: , et al Factors predicting outcome of fungal peritonitis in peritoneal dialysis: analysis of a 9-year experience of fungal peritonitis in a single center. Am J Kid Dis 2000;36:1183-1192
-
Martikainen TA, Ekstrand AV, Honkanen EO, Teppo AM, Gr+ Ânhagen-Riska C: Dialysate leukocytes, sICAM-1, hyaluronan and IL-6: predictors of outcome of peritonitis?. Blood Purif 2004;22:360-366
-
Lam MF, Leung JCK, Lam CWK: , et al Procalcitonin fails to differentiate inflammatory status or predict long-term outcomes in peritoneal dialysis-associated peritonitis. Perit Dial Int 2008;28:377-384
-
Gulati S, Stephens D, Balfe JA, Secker D, Harvey E, Balfe JW: Children with hypoalbuminemia on continuous peritoneal dialysis are at risk for technique failure. Kidney Int 2001;59:2361-2367
-
Blake PG, Flowerdew G, Blake RM, Oreopoulos DG: Serum albumin in patients on continuous ambulatory peritoneal dialysis -predictors and correlations with outcomes. J Am Soc Nephrol 1993;3:1501-1507
-
Choi P, Nemati E, Banerjee A, Preston E, Levy J, Brown E: Peritoneal dialysis catheter removal for acute peritonitis: a retrospective analysis of factors associated with catheter removal and prolonged postoperative hospitalization. Am J Kid Dis 2004;43:103-111
-
Bordes A, Campos-Herrero MI, Fernandez A, Vega N, Rodriguez JC, Palop L: Predisposing and prognostic factors of fungal peritonitis in peritoneal dialysis. Perit Dial Int 1995;15:275-276
-
Lo SHK, Chan CK, Shum HP, Chow VCC, Mo Kl, Wong KS: Risk factors for poor outcome of fungal peritonitis in Chinese patients on continuous ambulatory peritoneal dialysis. Perit Dial Int 2003;23:S123-S126
-
Matuszkiewicz-Rowinska J: Update on fungal peritonitis and its treatment. Perit Dial Int 2009;29:S161-S165
-
Goldie SJ, Kiernan-Troidle L, Torres C: , et al Fungal peritonitis in a large chronic peritoneal dialysis population: a report of 55 episodes. Am J Kid Dis 1996;28:86-91
-
Prasad KN, Prasad N, Gupta A, Sharma RK, Verma AK, Ayyagari A: Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: a single centre Indian experience. J Infect 2004;48:96-101
-
Szeto CC, Kwan BC-H, Chow KM: , et al Recurrent and relapsing peritonitis: causative organisms and response to treatment. Am J Kid Dis 2009;54:702-710
-
Moon SJ, Han SH, Kim DK: , et al Risk factors for adverse outcomes after peritonitis-related technique failure. Perit Dial Int 2008;28:352-360
Article / Publication Details
Published online: May 25, 2012
Cover Date: 2012
Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 1
ISBN: 978-3-318-02162-2 (Print)
eISBN: 978-3-318-02163-9 (Online)
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