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腹膜透析相关性腹膜炎的预测因素。

Predictor factors of peritoneal dialysis-related peritonitis.

作者信息

Lobo João Victor Duarte, Villar Keila Ribeiro, de Andrade Júnior Manoel Pacheco, Bastos Kleyton de Andrade

机构信息

Hospital Universitário, Universidade Federal de Sergipe, Aracaju, SE, Brasil.

出版信息

J Bras Nefrol. 2010 Apr-Jun;32(2):156-64.

Abstract

INTRODUCTION

Peritonitis remains a major complication of peritoneal dialysis (PD).

OBJECTIVE

Evaluate peritonitis incidence, etiology and outcome in cronic PD patients.

METHODS

A retrospective cohort study was carried out on 330 patients (mean age of 53 ± 19 years) who had been treated by PD in a dialysis center in Aracaju/SE, Brazil between January 1st, 2003 and December 31th, 2007. Data of patients with and without peritonitis were compared using Student's t-test, chi-squared statistic and multiple logistic regression.

RESULTS

There were 213 peritonitis among 141 patients (1.51 episode/patient) resulting in a rate of 28.44 patient/episode/ month (0.42 patient/episode/year). Staphylococcus aureus was the most frequent micro-organism isolated (27.8%), followed by Escherichia coli (13.4%) and 32.5% were culture-negative peritonitis. A greater risk of peritonitis was identified at the patients with hypoalbuminemia [relative risk (RR) = 2.0; 95% confidence interval (CI) = 1.21 - 3.43; p < 0,01], < 4 school years (RR = 2.15; CI = 1.09 - 4.24; p = 0.03) and catheter's exit site infection (RR = 2.63; IC = 1.57 - 4.41; p < 0.01). There were no significant difference among gender, age, family income, diabetes mellitus, type of dialysis treatment, type of catheter and its surgical implant.

CONCLUSIONS

Hypoalbuminemia, low schooling and catheter's exit site infection were associated with greater risk to peritonitis. Although peritonitis rate follow international pattern, prophylactic strategies are recommended.

摘要

引言

腹膜炎仍然是腹膜透析(PD)的主要并发症。

目的

评估慢性腹膜透析患者腹膜炎的发生率、病因及预后。

方法

对2003年1月1日至2007年12月31日在巴西阿拉卡茹/塞阿拉州一家透析中心接受腹膜透析治疗的330例患者(平均年龄53±19岁)进行回顾性队列研究。采用学生t检验、卡方统计和多元逻辑回归比较有腹膜炎和无腹膜炎患者的数据。

结果

141例患者发生213次腹膜炎(1.51次/患者),发生率为28.44患者/次/月(0.42患者/次/年)。金黄色葡萄球菌是最常见的分离微生物(27.8%),其次是大肠杆菌(13.4%),32.5%为培养阴性腹膜炎。低白蛋白血症患者发生腹膜炎的风险更高[相对风险(RR)=2.0;95%置信区间(CI)=1.21 - 3.43;p<0.01],受教育年限<4年(RR = 2.15;CI = 1.09 - 4.24;p = 0.03)以及导管出口处感染(RR = 2.63;IC = 1.57 - 4.41;p<0.01)。性别、年龄、家庭收入、糖尿病、透析治疗类型、导管类型及其手术植入之间无显著差异。

结论

低白蛋白血症、低受教育程度和导管出口处感染与腹膜炎风险增加相关。尽管腹膜炎发生率符合国际模式,但仍建议采取预防策略。

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