Gandhi Kunal, Prasad Dharmendra, Malhotra Vinay, Agrawal Dhananjai, Beniwal Pankaj, Leon Dsouza Amith Vijay
Department of Nephrology, Sawai Man Singh Hospital, Jaipur, Rajasthan, India.
Saudi J Kidney Dis Transpl. 2017 Sep-Oct;28(5):1133-1137. doi: 10.4103/1319-2442.215125.
A prospective observational study examining the incidence and microbiological aspects of peritonitis complicating acute intermittent peritoneal dialysis (IPD) was performed. A total of 145 acute IPD treatments were included involving 112 patients. The majority of patients suffered from acute kidney injury (72.3%) secondary to sepsis. Peritonitis occurred in 31 treatment sessions, giving a frequency of 21.4% of procedures performed. The mean interval between starting dialysis and the first sign of peritonitis was 2.9 days, with 58% of cases occurring in the Intensive Care Unit. Frequent catheter manipulation/repositioning and leakages were identified as significant predisposing factors for peritonitis, and the risk of peritonitis was increased with longer duration of IPD. Gram-negative infections were more common than Grampositive infections. The use of systemic antibiotics did not prevent the development of peritonitis.
开展了一项前瞻性观察性研究,以检查并发急性间歇性腹膜透析(IPD)的腹膜炎的发生率及微生物学情况。共纳入145次急性IPD治疗,涉及112例患者。大多数患者继发于败血症的急性肾损伤(72.3%)。31个治疗疗程发生了腹膜炎,占所进行操作的21.4%。开始透析至腹膜炎首个迹象的平均间隔时间为2.9天,58%的病例发生在重症监护病房。频繁的导管操作/重新定位和渗漏被确定为腹膜炎的重要诱发因素,且IPD持续时间越长,发生腹膜炎的风险越高。革兰阴性菌感染比革兰阳性菌感染更常见。全身使用抗生素并不能预防腹膜炎的发生。