Department of Medicine, Renal Division, Zadar County Hospital, Zadar, Croatia.
Int Urol Nephrol. 2013 Apr;45(2):519-25. doi: 10.1007/s11255-012-0257-2. Epub 2012 Aug 15.
Prevalence of peritoneal dialysis is low in part because of the perceived high risk for complications such as peritonitis. However, in the most recent era, peritonitis incidence and its effects on patient outcomes may have diminished. The aim of this study was to analyze peritonitis incidence and its impact on patient and technique survival, as well as on the kidney transplantation rate and outcome.
All peritoneal dialysis patients from a county hospital between year 2001 and 2011 were retrospectively included. Patients were divided into two groups with respect to peritonitis. The primary composite end-point consisted of a 3-year patient mortality or technique loss. Secondary end-points were patient survival and probability of kidney transplantation with respect to peritonitis history.
Among 85 study patients, there were 61 peritonitis episodes. The incidence of peritonitis was 0.339 ± 0.71 episode per patient per 12 months or one episode per 29.3 ± 22.2 patient-months. The time to peritonitis was shorter, and peritonitis was more likely in patients on continuous ambulatory peritoneal dialysis than in automated peritoneal dialysis patients. Patient and technique survival and transplantation rate were similar in the group with and without peritonitis history. The primary end-point was recorded in 35 % of patients with peritonitis history and in 54 % of those without peritonitis (p = 0.04). In a multivariate analysis, the only variable significantly associated with the primary end-point and with patient survival was patient age at start of peritoneal dialysis.
In contemporary peritoneal dialysis patients, timely treated peritonitis may not be associated with adverse patient and technique outcomes. The transplantation rate is unaffected by the peritonitis history. Peritoneal dialysis may be promoted as the first dialysis method in appropriate patients.
腹膜透析的普及率较低，部分原因是人们认为其存在较高的并发症风险，如腹膜炎。然而，在最近一段时间，腹膜炎的发病率及其对患者预后的影响可能已经降低。本研究旨在分析腹膜炎的发病率及其对患者和技术生存率的影响，以及对肾移植率和结局的影响。
回顾性纳入 2001 年至 2011 年间县医院的所有腹膜透析患者。根据腹膜炎的发生情况将患者分为两组。主要复合终点包括 3 年患者死亡率或技术损失。次要终点为腹膜炎病史对患者生存率和肾移植概率的影响。
在 85 例研究患者中，共发生 61 例腹膜炎。腹膜炎的发病率为 0.339±0.71 例/患者/12 个月，或每 29.3±22.2 患者-月发生 1 例。持续性非卧床腹膜透析患者腹膜炎的发生时间更短，且更易发生腹膜炎。腹膜炎病史组和无腹膜炎病史组患者的生存率和移植率相似。腹膜炎病史组中有 35%的患者和无腹膜炎病史组中有 54%的患者达到了主要终点（p=0.04）。多变量分析显示，与主要终点和患者生存率显著相关的唯一变量是腹膜透析开始时患者的年龄。
在当代腹膜透析患者中，及时治疗的腹膜炎可能不会导致不良的患者和技术结局。腹膜炎病史对移植率没有影响。腹膜透析可以作为合适患者的首选透析方法。
