1. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks
- Author
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Raaijmakers, Renske, Gajjar, Priya, Schroder, Cornelis, and Nourse, Peter
- Subjects
Pediatrics -- Health aspects ,Developing countries -- Health aspects ,Children -- Health aspects ,Epidemiology -- Health aspects ,Peritonitis -- Risk factors -- Care and treatment -- Health aspects ,Health - Abstract
Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and peritonitis epidemiology in pediatric patients in South Africa and identify risk factors for peritonitis. Baseline characteristics and potential risk factors of peritonitis were recorded, including housing, socio-economic circumstances, distance to PD center, type of PD, mode of catheter placement, race, presence of gastrostomy tube, weight, and height. Outcome indices for peritonitis were peritonitis rate, time to first peritonitis, and number of peritonitis-free patients. The patient cohort comprised 67 patients who were on PD for a total of 544 months. The total number of peritonitis episodes was 129. Median peritonitis rate was one episode every 4.3 patient months (2.8 episodes/patient-year, range 0-21.2). Median time to first infection was 2.03 months (range 0.1-21.5 months), and 28.4% of patients remained free from peritonitis. Patients with good housing and good socioeconomic circumstances had a significantly lower peritonitis rate and a longer time to first peritonitis episode. Peritonitis rate was high in this cohort, compared to numbers reported for the developed world; the characteristics of causative organisms are comparable. The most important risk factors for the development of peritonitis were poor housing and poor socioeconomic circumstances. More intensive counseling may be beneficial, but improvement of general socio-economic circumstances will have the greatest influence on PD success. Keywords Peritonitis * Pediatric * Risk factors Socio-economic circumstances * Outcome, Introduction Frequently occurring diseases in developing countries, such as acquired immunodeficiency syndrome (AIDS), tuberculosis, malaria, gastro-enteritis, and hypertension are often complicated by renal diseases [1]. No reliable statistics are available [...]
- Published
- 2010
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