腹膜透析相关性腹膜炎:发病率、临床结果和患者生存率。

Pavlina Dzekova-Vidimliski, Igor G Nikolov, Nikola Gjorgjievski, Gjulsen Selim, Lada Trajceska, Ana Stojanoska, Irena Rambabova-Bushljetik, Risto Simeonov, Ljupco Stojkovski
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引用次数: 5

摘要

腹膜透析相关性腹膜炎仍然是腹膜透析(PD)长期成功的主要并发症和主要挑战。本研究旨在分析腹膜透析患者腹膜炎的发生率、原因、结局以及腹膜炎与生存的关系。从病历中回顾性收集患者资料。1999年1月1日至2018年12月31日,共有96名患者在PD中心接受腹膜透析。54例(56.3%)患者发生腹膜炎(n=159)。研究人群分为两组,一组有腹膜炎的患者(n=54)和一组无腹膜炎的患者(n=42)。腹膜炎发生率为0.47次/例/年。病原菌以革兰氏阳性菌居多(53.5%)。腹膜炎发作的结局是84.9%的腹膜炎感染消退,11.3%的腹膜炎导管拔除,3.8%的腹膜炎死亡。Kaplan-Meier分析和log-rank检验显示,腹膜炎组的生存时间明显长于无腹膜炎组。与无腹膜炎组相比,腹膜炎组患者死亡风险降低67%(风险比:0.33,95% CI 0.19-0.57, P=0.000)。PD相关感染的预防和管理,导致其在全球范围内减少,支持使用PD作为一线透析方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Peritoneal Dialysis-Related Peritonitis: Rate, Clinical Outcomes and Patient Survival.

Peritoneal dialysis-related peritonitis remains the major complication and primary challenge to the long-term success of peritoneal dialysis (PD). The study aimed to analyze the peritonitis rate, the cause, the outcomes, and the association of peritonitis with the survival of patients on peritoneal dialysis. Patient data were collected retrospectively from medical charts. A total of 96 patients received peritoneal dialysis in the PD center from 1 January 1999 to 31 December 2018. Episodes of peritonitis (n=159) were registered in 54 (56.3%) patients. The study population was divided into two groups, a group of patients (n=54) who experienced peritonitis and a group of patients free of peritonitis (n=42). The peritonitis rate was 0.47 episodes per patient year. The majority of causative microorganisms were gram-positive bacteria (53.5%). Outcomes of the episodes of peritonitis were resolved infection in 84.9% of episodes, catheter removal in 11.3% of episodes, and death in 3.8% of the episodes of peritonitis. A Kaplan-Meier analysis and log-rank test revealed that the group with peritonitis tended to survive significantly longer than the peritonitis-free group. A 67% reduction rate in the risk of patient mortality was observed for the peritonitis group compared with the peritonitis-free group (hazard ratio: 0.33, 95% CI 0.19-0.57, P=0.000). The prevention and management of PD-related infections, resulted in their worldwide reduction, supporting the use of PD as a first-line dialysis modality.

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