Risk Factors Anal Sis in Ieritoneal Dialysis-Related Peritonitis

腹膜透析相關之腹膜炎的危險因子分析

賴宇軒(Yu-Hsien Lai) ； 蔡任弼(Jen-Pi Tsai) ； 沈祖望(Tsu-Wang Shen) ； 王智賢(Chih-Ksien Wang) ； 徐邦治(Bang-Gee Hsu) ； 方德昭(Te-Chao Fang)

《Acta Nephrologica》 24卷3期 (2010/07) Pp. 138-144

摘要

Objectives: To determine the independent risk factor (s) of treatment failure (either catheter removal or death) in PD-related peritonitis.
Methods: Seventy-five end-stage renal disease patients on long-term PD and with episodes of peritonitis from 1997 to 2006 were recruited. Both baseline characteristics and initial clinical manifestations of PD-related peritonitis with treatment success and treatment failure were analyzed. Treatment success of PD-related peritonitis meant recovery from peritonitis while treatment failure was defined as either death of the patient owing to peritonitis or catheter removal with a shift to hemodialysis.
Results: There were 46 episodes of PD-related peritonitis during the 10-year study period. The most common organism causing PD-related peritonitis was Gram-positive (34.7%). The percentage of culture-negative was 19.6%. The treatment failure for PD-related peritonitis totaled 30.5% (14/46), including 6.5% (3/46) mortality and 24% (11/46) catheter removal. Treatment failure was significantly associated with higher blood neutrophil count (p=0.045) and dialysate culture with fungi, Mycobacterial species, polymicrobial organisms and Pseudomonas species (FMPP) (p＜0.001). Multivariate logistic regression analysis showed that treatment failure was significantly associated with blood neutrophil count (log-transformed) (adjusted odds ratio=216, p=0.018) and specific organisms FMPP (adjusted odds ratio =40.6, p=0.001).
Conclusion: Blood neutrophil count and dialysate culture with specific organisms FMPP were independent risk factors for treatment failure in PD patients with peritonitis.

關鍵字

末期腎臟衰竭 ； 腹膜透析 ； 腹膜炎

並列摘要

Objectives: To determine the independent risk factor (s) of treatment failure (either catheter removal or death) in PD-related peritonitis.
Methods: Seventy-five end-stage renal disease patients on long-term PD and with episodes of peritonitis from 1997 to 2006 were recruited. Both baseline characteristics and initial clinical manifestations of PD-related peritonitis with treatment success and treatment failure were analyzed. Treatment success of PD-related peritonitis meant recovery from peritonitis while treatment failure was defined as either death of the patient owing to peritonitis or catheter removal with a shift to hemodialysis.
Results: There were 46 episodes of PD-related peritonitis during the 10-year study period. The most common organism causing PD-related peritonitis was Gram-positive (34.7%). The percentage of culture-negative was 19.6%. The treatment failure for PD-related peritonitis totaled 30.5% (14/46), including 6.5% (3/46) mortality and 24% (11/46) catheter removal. Treatment failure was significantly associated with higher blood neutrophil count (p=0.045) and dialysate culture with fungi, Mycobacterial species, polymicrobial organisms and Pseudomonas species (FMPP) (p＜0.001). Multivariate logistic regression analysis showed that treatment failure was significantly associated with blood neutrophil count (log-transformed) (adjusted odds ratio=216, p=0.018) and specific organisms FMPP (adjusted odds ratio =40.6, p=0.001).
Conclusion: Blood neutrophil count and dialysate culture with specific organisms FMPP were independent risk factors for treatment failure in PD patients with peritonitis.

並列關鍵字

End-stage renal failure ； peritoneal dialysis ； peritonitis