Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Acute Medicine, The University of Tokyo Hospital, Bunkyo-ku, Japan.
Sci Rep. 2021 Mar 22;11(1):6547. doi: 10.1038/s41598-021-86071-y.
For peritonitis, a serious complication of peritoneal dialysis (PD), we investigated the relation between duration from the sign (PD effluent abnormalities) to treatment with appropriate antibiotics (ST time) and catheter removal. For 62 PD hospital patients, data of PD-related peritonitis (n = 109) were collected retrospectively. We examined ST time and PD catheter removal times using univariate and multivariate analyses. The catheter removal rate in the delayed ST time group (≥ 24 h) was higher than that in early ST time group (< 24 h) (38 vs. 16%, p = 0.02). Concomitant tunnel infection and delayed ST time were associated with catheter removal (OR [95% CI] 32.3 [3.15-329] and 3.52 [1.11-11.1]). Rates of catheter removal and re-development of peritonitis within 1 month after starting treatment were higher in the delayed ST time group (p = 0.02). PD duration at peritonitis and the first peritonitis episode were associated with delayed ST time (1.02 [1.00-1.04] and 3.42 [1.09-10.7]). Significant association was found between PD catheter removal and the start of treatment more than 24 h after appearance of abnormal effluent. Education for patients about prompt visitation at the onset of peritonitis with long PD duration might improve outcomes.
对于腹膜透析（PD）的严重并发症腹膜炎，我们研究了从出现症状（PD 流出液异常）到开始使用适当抗生素治疗（ST 时间）与导管去除之间的关系。我们回顾性地收集了 62 名 PD 住院患者的 PD 相关腹膜炎（n=109）数据。我们使用单变量和多变量分析检查了 ST 时间和 PD 导管去除时间。延迟 ST 时间组（≥24 小时）的导管去除率高于早期 ST 时间组（<24 小时）（38%比 16%，p=0.02）。隧道感染和延迟 ST 时间与导管去除有关（OR[95%CI]32.3[3.15-329]和 3.52[1.11-11.1]）。在开始治疗后 1 个月内，延迟 ST 时间组的导管去除率和再次发生腹膜炎的比率更高（p=0.02）。腹膜炎时 PD 持续时间和首次腹膜炎发作与延迟 ST 时间有关（1.02[1.00-1.04]和 3.42[1.09-10.7]）。在 PD 流出液异常出现后超过 24 小时开始治疗与 PD 导管去除之间存在显著相关性。对于 PD 持续时间较长的腹膜炎患者，在发病时及时就诊并进行治疗的教育可能会改善预后。
