Peritonitis in Children on Chronic Peritoneal Dialysis: The Experience of a Large National Pediatric Cohort

Blood Purif. 2018;45(1-3):118-125. doi: 10.1159/000484344. Epub 2017 Dec 14.

Abstract

Background: We performed this study to evaluate the incidence, risk factors, microbiology, treatment, and outcome of peritonitis in pediatric Peritoneal dialysis (PD) patients at a nationwide prospective study.

Methodology: Patients younger than 18 years recruited in the BRAZPD II study from 2004 to 2011, who presented their first peritonitis episode, were included in the study.

Results: We found 125 first episodes of peritonitis in 491 children PD patients (0.43 episodes/patient-year). Patients free of peritonitis episode constituted 75.6% in 1 year. Culture-negative episodes were very high (59.2%) and gram-positive (GP) bacteria were the most commonly found organisms (58.8%). First-generation cephalosporin was the initial choice to cover GP (40.5%) and aminoglycosides was the most prescribed antibiotics used for gram-negative agents (27.5%). Treatment failure was 26.4%. Technique failure (TF) occurred in 12.1% and peritonitis was the main cause (65.1%). Pseudomonas (p = 0.04) and negative cultures (p < 0.001) were identified as predictors of TF.

Conclusion: Peritonitis remains a common complication of PD in children and negative cultures and pseudomonas had a negative impact on TF.

Keywords: Children; Peritoneal dialysis; Peritonitis and outcome.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Gram-Negative Bacterial Infections* / drug therapy
  • Gram-Negative Bacterial Infections* / etiology
  • Gram-Negative Bacterial Infections* / mortality
  • Gram-Positive Bacterial Infections* / drug therapy
  • Gram-Positive Bacterial Infections* / etiology
  • Gram-Positive Bacterial Infections* / mortality
  • Humans
  • Male
  • Peritoneal Dialysis / adverse effects*
  • Peritonitis* / drug therapy
  • Peritonitis* / etiology
  • Peritonitis* / mortality
  • Prospective Studies

Substances

  • Anti-Bacterial Agents