Incidence and Risk Factors of Peritoneal Dialysis Related Infection at Suwannaphum Hospital
Keywords:
peritonitis, peritoneal dialysis, risk factors, infectionAbstract
Background and Objectives: Peritoneal dialysis is an important and widely used renal replacement therapy for patients with end-stage chronic kidney disease. However, peritonitis remains the major cause of treatment failure or obstacle in peritoneal dialysis patients. This study aimed to study the incidence and risk factors of peritoneal dialysis related infection at Suwannaphum Hospital.
Methods: This study was a retrospective cohort study that collected data from the medical records of patients undergoing peritoneal dialysis who received treatment at the CAPD clinic, Suwannaphum Hospital, from January 1, 2015, to December 31, 2021, total 160 patients. Data analysis included descriptive statistics, univariate analysis, and multivariable logistic regression, with a significance level set at p < 0.05.
Results: A total of 160 patients undergoing peritoneal dialysis were studied, 93 developed peritonitis, with the incidence of peritonitis over a one-year period was 0.24 episodes per patient-year. Of 156 infection episodes most patients were male (54.38%) with mean aged 59.96 years (S.D. = 9.96). The most common symptom was abdominal pain with cloudy dialysis fluid without fever (48.08%). Peritoneal fluid culture were found negative in 60.90% in peritoneal dialysis related infection. The predominant pathogens were gram-positive cocci, especially Staphylococcus spp. (14.74%), while Klebsiella pneumoniae was the most frequent gram-negative bacteria (4.49%). After adjusting for sex, significant factors associated with peritonitis included aged 61–70 years (Adjusted OR (AOR) = 3.52; 95% CI: 1.57–21.61), age > 70 years (AOR = 22.79; 95% CI: 2.05–25.31), WBC > 10,000 cells/mL (AOR = 10.62; 95% CI: 3.25–34.71), sodium < 135 mmol/L (AOR = 2.50; 95% CI: 1.70–6.08), and serum albumin < 3.5 g/dL (AOR = 12.58; 95% CI: 4.14–38.13).
Conclusion: This study found that the incidence of peritonitis over a one-year period was 0.24 episodes per patient-year. Key factors associated with its occurrence included age over 60 years, high white blood cell count in blood, low serum sodium, and low serum albumin. These findings supported effective monitoring and management to prevent and reduce peritonitis risk in this population.
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