Microbiology Risk Factors and Outcomes of Peritonitis in Tunisian Peritoneal Dialysis Patients

Background: Peritonitis is a major complication of peritoneal dialysis (PD), accounting for considerable mortality and hospitalization among PD patients. We have performed a single unit study examining rate of peritonitis, causative organisms, clinical outcomes and impact on technique failure and patient survival. Methods: It was a retrospective review of the medical records of 182 PD patients who were followed up from January 2006 through June 2016. We have listed 186 episodes of peritonitis. Results: The overall incidence of peritonitis during the 10-year study period was one episode every 27.25 month-patient. The mean time to first peritonitis after beginning PD was 14.25 ± 16 months (0 - 65). Gram-positive organisms were the main implicated agents and caused 27.92% of peritonitis. In multivariate Cox regression, no correlation was associated with diabetes, cardiovascular disease and residual renal function at baseline. In the Kaplan-Meier analysis, the peritonitis group was not correlated with more loss of residual renal function. More dropouts from PD were observed compared to the peritonitis-free group (P < 0.000), but no influence with patient survival. Conclusion: Gram-positive organisms were the main causative agents. And peritonitis was associated to technique failure but not with patient survival.Z World J Nephrol Urol. 2018;7(2):45-52 doi: https://doi.org/10.14740/wjnu349w