Iida Hidekazu, Kurita Noriaki, Fujimoto Shino, Kamijo Yuka, Ishibashi Yoshitaka, Fukuma Shingo, Fukuhara Shunichi
Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan.
Department of Clinical Epidemiology, Fukushima Medical University, Fukushima City, Fukushima, Japan.
Int Urol Nephrol. 2018 Apr;50(4):763-769. doi: 10.1007/s11255-018-1789-x. Epub 2018 Jan 18.
To prevent peritoneal dialysis (PD)-related infection, components of self-catheter care have been emphasized. However, studies on the effectiveness of home recording for the prevention of PD-related infections are limited. This study aimed to examine the association between keeping home records of catheter exit site and incidence of PD-related infections.
Home record books were submitted by patients undergoing PD. The proportion of days on which exit-site home recording was carried out for 120 days (0-100%) was obtained. The patients were divided into the frequent home recording group (≥ 40.5%; median value) and the infrequent home recording group (< 40.5%). The associations between the recording group and the incidence rate ratios (IRRs) of PD-related infections were estimated via negative binomial regression models.
A total of 67 patients participated in this study (mean age, 66.7 years). The incidence rates for exit-site infection, tunnel infection, and peritonitis were 0.42, 0.22, and 0.06 times/patient-year, respectively. The IRRs of the frequent versus infrequent home recording groups for PD-related infection were 1.58 (95% confidence interval [CI], 0.72-3.46) in the univariate analysis and 1.49 (95% CI, 0.65-3.42) in the multivariate analysis. The IRRs of the frequent versus infrequent home recording groups for composite of surgery to create a new exit site and removal of PD catheter were 0.55 (95% CI, 0.78-3.88) and 0.35 (95% CI, 0.06-1.99), respectively.
This study could not prove that keeping home records of patients' catheter exit site is associated with a lower incidence of PD-related infections.
为预防腹膜透析（PD）相关感染，自我导管护理的各个组成部分已得到强调。然而，关于居家记录对预防PD相关感染有效性的研究有限。本研究旨在探讨导管出口处居家记录与PD相关感染发生率之间的关联。
接受PD治疗的患者提交居家记录册。计算120天内进行出口处居家记录的天数比例（0 - 100%）。将患者分为频繁居家记录组（≥40.5%；中位数）和不频繁居家记录组（<40.5%）。通过负二项回归模型估计记录组与PD相关感染的发病率比（IRR）。
共有67例患者参与本研究（平均年龄66.7岁）。出口处感染、隧道感染和腹膜炎的发生率分别为0.42、0.22和0.06次/患者年。在单因素分析中，频繁与不频繁居家记录组的PD相关感染IRR为1.58（95%置信区间[CI]，0.72 - 3.46），多因素分析中为1.49（95%CI，0.65 - 3.42）。频繁与不频繁居家记录组进行新出口处创建手术和拔除PD导管综合情况的IRR分别为0.55（95%CI，0.78 - 3.88）和0.35（95%CI，0.06 - 1.99）。
本研究无法证明患者对导管出口处进行居家记录与较低的PD相关感染发生率有关。
