The Japanese Journal of Clinical Dialysis Vol.28 No.5(4-2)

Theme Trend in Peritoneal Dialysis Therapy After Implementation of Japanese Society for Dialysis Therapy (JSDT) Peritoneal Dialysis Guideline
Title Analysis of PD -- related peritonitis in institutes affiliated with Nagoya University Renal Replacement Therapy Association
Publish Date 2012/05
Author Yasuhiko Ito Department of Renal Replacement Therapy and Nephrology, Nagoya University Graduate School of Medicine / Department of Nephrology, Nagoya University Graduate School of Medicine
Author Masashi Mizuno Department of Renal Replacement Therapy and Nephrology, Nagoya University Graduate School of Medicine / Department of Nephrology, Nagoya University Graduate School of Medicine
Author Yasuhiro Suzuki Department of Renal Replacement Therapy and Nephrology, Nagoya University Graduate School of Medicine / Department of Nephrology, Nagoya University Graduate School of Medicine
Author Seiichi Matsuo Department of Nephrology, Nagoya University Graduate School of Medicine
[ Summary ] PD related peritonitis is the most common acute complication associated with PD. It is also the primary reason for withdrawal of treatment. The incidence of peritonitis has been reduced through implemention of new connection systems. Recently, a report from the UK illustrated a high incidence of peritonitis still exhists and is the major cause of discontinuance from PD and switching to HD. We organized a registry to analyze patients and retrospectively investigated 561 PD patients from 13 affiliated hospitals affiliated with Nagoya University. We found that PD-related peritonitis, mainly cased by Gram-positive organisms, was the most common cause of withdrawal from PD. Notably, culture-negative results were obtained from 32 % of peritonitis cultures. That was worse than the recommendations made in the recent ISPD guidelines / recommendations that culture negative results should be less than 20 %. Many empirical regimens for antibiotic use were implemented in those hospitals, which were different from the ISPD recommendations. Educational systems to decrease the incidence of peritonitis, techniques to decrease culture-negative results and optimal treatment with antibiotics, based on the ISPD guidelines, may be important in terms of improving the prognoses for patients with peritonitis. Statistics concerning of PD-related infections should be included in the Japanese guidelines.
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