1. Risk factors for early onset peritonitis: the SCOPE collaborative.
- Author
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Keswani M, Redpath Mahon AC, Richardson T, Rodean J, Couloures O, Martin A, Blaszak RT, Warady BA, and Neu A
- Subjects
- Age Factors, Catheter-Related Infections etiology, Female, Humans, Infant, Male, Peritoneal Dialysis instrumentation, Peritonitis etiology, Prospective Studies, Risk Assessment, Risk Factors, Time Factors, Catheter-Related Infections epidemiology, Catheters, Indwelling adverse effects, Kidney Failure, Chronic therapy, Peritoneal Dialysis adverse effects, Peritonitis epidemiology
- Abstract
Background: Peritoneal dialysis (PD) is the preferred chronic dialysis modality amongst pediatric patients. Peritonitis is a devastating complication of PD. Adult data demonstrates early onset peritonitis (EP) is associated with higher rates of subsequent peritonitis and technique failure. Limited data exists regarding EP in the pediatric population, here defined as peritonitis occurring within 60 days of catheter insertion., Methods: PD catheter insertion practices and EP episodes were examined from the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) collaborative database., Results: There were 98 episodes of EP amongst 1106 PD catheters inserted. Multivariable analysis demonstrated a significant association between early use of the PD catheter and EP (P = 0.001). Age less than 1 year at the time of catheter insertion (P < 0.001), first catheter placed (P < 0.001) for the patient, use of a plastic adapter (P = 0.003), placement of sutures at the exit site (ES) (P = 0.032), and dressing change prior to 7 days post-operatively (P < 0.001) were all significantly associated with early PD catheter use. Concurrent placement of a hemodialysis catheter was associated with a decreased risk for early PD catheter use (P = 0.010)., Conclusions: In this large cohort of pediatric PD recipients, 8.4% of PD catheters were associated with the development of EP. The finding of an association between early use of the PD catheter and EP represents a potentially modifiable risk factor to reduce infection rates within this patient population.
- Published
- 2019
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