Bach Nguyen, Chi Trinh Thi Kim, Trung Lu Cong, Ngoc Nguyen Hoang Bao, Hoa Thai Pham Thi, Huynh Thao Ngoc Phuong, Khai Truong Hoang, Dao Dang Anh, Tuoc Phan Xuan, Dung Vuong Quoc
Department of Nephrology and Dialysis, Thong Nhat Hospital, 01 Ly Thuong Kiet Street, Tan Binh District, Ho Chi Minh City, Vietnam.
Department of Nephrology and Dialysis, An Giang Central General Hospital, 60 Ung Van Khiem, Long Xuyen, An Giang, Vietnam.
BMC Nephrol. 2025 Mar 11;26(1):134. doi: 10.1186/s12882-025-04061-y.
Chronic kidney disease (CKD) is a substantial contributor to global mortality, requiring interventions like kidney transplantation and dialysis. Peritoneal dialysis (PD) has emerged as an effective dialytic modality despite the susceptibility to peritonitis. The study aimed to determine the prevalence of peritonitis among PD patients, elucidating pivotal factors affecting its occurrence, causative bacterial agents, and treatment outcomes (mortality rates, removal of the Tenckhoff catheter, and switch to hemodialysis).
A retrospective cohort study was conducted, which included patients who underwent PD between January 2019 and December 2021 at nine dialysis centers in Vietnam. The prevalence rate of peritonitis was estimated as the quotient of total peritonitis episodes and cumulative patient-years. The association of peritonitis with factors such as age, care (self-care or helper-assisted PD), comorbidities, education level was analyzed using regression analysis. Peritonitis outcomes including mortality rate, Tenckhoff catheter removal, and transitions to hemodialysis were evaluated. PD-related infections were assessed. Additionally, the causative bacterial agents and the negative culture rate were determined.
A total of 691 PD patients from nine centers from the south of Vietnam were recruited for the study. Peritonitis was reported in 32.42% of the patients during the study period of 2019-2021. An increase in the number of patients reporting peritonitis was observed over the years. A significant association (p = 0.01) between peritonitis rate and level of literacy was found. The mortality rate among patients who underwent PD was 2.68%. About 16.18% of patients with peritonitis had to have the Tenckhoff catheter removed and needed to be switched to hemodialysis. Around 46.98% of the peritonitis cases were culture-positive.
The prevalence of peritonitis among PD patients in Vietnam increased from 2019 to 2021. Lower literacy positively correlated with peritonitis, regardless of the type of PD. The high prevalence of culture-negative peritonitis cases indicated gaps in diagnostic procedures or the presence of unusual pathogens. These outcomes highlight the need for improved education, diagnostic practices, and interventions to reduce peritonitis risks and enhance patient care in PD programs in Vietnam.
慢性肾脏病（CKD）是全球死亡率的一个重要因素，需要肾脏移植和透析等干预措施。尽管存在腹膜炎易感性，但腹膜透析（PD）已成为一种有效的透析方式。本研究旨在确定PD患者中腹膜炎的患病率，阐明影响其发生的关键因素、致病细菌病原体以及治疗结果（死亡率、Tenckhoff导管拔除率和转为血液透析率）。
进行了一项回顾性队列研究，纳入了2019年1月至2021年12月期间在越南9个透析中心接受PD治疗的患者。腹膜炎患病率估计为腹膜炎发作总数与累积患者年数的商。使用回归分析分析腹膜炎与年龄、护理方式（自我护理或辅助护理的PD）、合并症、教育水平等因素之间的关联。评估腹膜炎的结果，包括死亡率、Tenckhoff导管拔除率和转为血液透析的情况。评估与PD相关的感染情况。此外，确定致病细菌病原体和阴性培养率。
共招募了来自越南南部9个中心的691例PD患者进行研究。在2019 - 2021年的研究期间，32.42%的患者报告发生了腹膜炎。多年来报告腹膜炎的患者数量有所增加。发现腹膜炎发生率与识字水平之间存在显著关联（p = 0.01）。接受PD治疗的患者死亡率为2.68%。约16.18%的腹膜炎患者不得不拔除Tenckhoff导管并需要转为血液透析。约46.98%的腹膜炎病例培养呈阳性。
2019年至2021年期间，越南PD患者中腹膜炎的患病率有所增加。无论PD类型如何，较低的识字水平与腹膜炎呈正相关。培养阴性腹膜炎病例的高患病率表明诊断程序存在差距或存在不寻常的病原体。这些结果凸显了在越南的PD项目中需要改进教育、诊断方法和干预措施，以降低腹膜炎风险并加强患者护理。
