Troidle Laura, Gorban-Brennan Nancy, Kliger Alan, Finkelstein Fredric O
New Haven CAPD, Renal Research Institute, New Haven, Connecticut, USA.
Semin Dial. 2003 Nov-Dec;16(6):428-37. doi: 10.1046/j.1525-139x.2003.16095.x.
The percentage of end-stage renal disease (ESRD) patients in the United States maintained on continuous peritoneal dialysis (CPD) therapy is decreasing. Complications from CPD therapy, including peritonitis, may be the reason for the decline. Improvements in CPD technology and a better understanding of the risk factors that predispose patients to the development of peritonitis have been responsible for a decline in the rate of peritonitis. Yet peritonitis remains a significant cause of patient morbidity and mortality and the overall outcome of peritonitis is not acceptable. Factors that have limited our ability to lessen the impact of peritonitis include a lack of data on dosing antibiotics in patients on continuous cycling peritoneal dialysis (CCPD) therapy, a lack of knowledge concerning the biology of bacterial biofilm, and the development of resistance to the current prophylactic antibiotic protocols. Further studies are needed concerning the optimal management of the peritoneal catheter and whether it is feasible to resume CPD therapy after catheter removal.
在美国，接受持续腹膜透析（CPD）治疗的终末期肾病（ESRD）患者比例正在下降。CPD治疗的并发症，包括腹膜炎，可能是导致这种下降的原因。CPD技术的改进以及对使患者易患腹膜炎的危险因素的更好理解，已导致腹膜炎发生率下降。然而，腹膜炎仍然是患者发病和死亡的重要原因，且腹膜炎的总体结局并不理想。限制我们减轻腹膜炎影响能力的因素包括缺乏关于持续循环腹膜透析（CCPD）治疗患者抗生素给药的数据、对细菌生物膜生物学的了解不足以及对当前预防性抗生素方案产生耐药性。需要进一步研究腹膜导管的最佳管理方法，以及在拔除导管后恢复CPD治疗是否可行。
