Outcome of peritoneal-dialysis related peritonitis in children: A single center experience

Abstract

INTRODUCTION: The aim of this study was to clarify the etiology, clinical presentation, treatment of peritonitis, peritonitis rate, and to analyze the microbiologic profile of peritonitis in our pediatric dialysis unit. METHODS: This study was performed with children treated with chronic peritoneal dialysis and diagnosed for peritonitis during the period from January 2004 to December 2011 at the Peritoneal Dialysis Unit of our Pediatric Nephrology Department. RESULTS: The patient cohort comprised 55 patients (30 males, 25 females) who were treated for peritoneal dialysis related peritonitis. The total number of peritonitis episodes was 157. The mean peritonitis rate was one episode per 23.9 patient-months; one episode per 26.8 patient-months for continuous ambulatory peritoneal dialysis and one episode per 20.1 patient-months for automated peritoneal dialysis. The yield of culture positivity was 69.5% with %42.6 gram-positive, 19.7% gram-negative, 3.8% polymicrobial gram-positive, 0.6% polymicrobial gram-negative, 0.6% polymicrobial mixed, 1.3% fungal and 0.6% anaerobic organisms. Coagulase-negative staphylococcus was the most common cause, accounting for 17.1% of all episodes. The mean number of peritonitis episodes was 3±2.3 in 42 patients with double-cuffed swan neck catheter whereas the number of peritonitis episodes was 2.3±1.6 in 13 patients with double-cuffed tenckhoff catheter. There was no relation between catheter type and the number of peritonitis episodes (p>0.05). DISCUSSION and CONCLUSION: In conclusion, neither the dialysis modality, catheter type, nor the catheter insertion techniques have a definite effect on the development of a perionitis episode. This directs us to consider the importantance of the training program given to the caregivers.