Retrospective Analysis On Clinical Risk Factors Of Peritoneal Dialysis-related Peritonitis At A Single Center

Background: Peritoneal dialysis (PD) is the most important familydialysis treatment for patients with end-stage kidney disease (ESRD),andPD related peritonitis is the main complication.In recent years, with thecontinuous improvement of peritoneal dialysis technology and thestandardization of the management center, peritonitis rates declined, but itstill is one of the most common cause of PD patients in the hospitaltreatment, its severity will directly affect the effect of peritoneal dialysisand patients’ survival rate.Purpose: This study retrospectively analyzed the clinical data ofperitoneal dialysis patients in nearly four years in our hospital, whichsummarizes the pathogenic bacteria of peritonitis,explores risk factors forperitoneal dialysis related peritonitis, and provides clinical guidance forprevention and treatment of peritoneal dialysis related peritonitis.Methods：Patients in ward were planted by peritoneal dialysis inthe first hospital of jilin university during2009to2013,according to thecriterion of peritonitis,divide into peritonitis and never peritonitisgroups.Record gender, antihepatitis C virus antibody positivity,theprimary disease,calcitriol application,smoking, former form of PD, coronary heart disease, cerebrovascular disease, intestinal disorders(diarrhea or constipation), peritoneal liquid culture, age, albumin,hemoglobin, serum creatinine, calcium, phosphorus and parathyroidhormone.Summarize the pathogenic bacteria of peritonitis, clarify the riskfactors of peritoneal dialysis related peritonitis.Results:1. The group of115cases,41cases of54times peritonealdialysis related peritonitis,74cases of no peritonitis happen.45cases ofpathogen culture were found positive, positive rate was83.33%,amongwhich26cases (57.78%) were infected with gram positive cocci，12cases(26.67%) with gram negative cocci and7cases (15.56%) withfungi.Staphylococcus epidermidis in Gram-positive bacteria wasaccounted for the highest,7cases, most of gram-negative bacteria was e.coli,6cases.2. With the use of Logistic regression analysis for the clinical dataof two groups of patients, the results show that serum albumin, serumphosphate, diarrhea or constipation and applying calcitriol are acceptedby the regression equation,ROC curve of albumin and serum phosphateshowed that area under curve are0.831（95%[CI]:0.759-0.902）and0.700（95%[CI]:0.608-0.791）respectively.Optimal cut off point of serumalbumin is29.1g/L,and optimal cut off point of serum phosphate is1.795mmol/L.Conclusion:1.The peritoneal dialysis related peritonitis is given priority to with gram-positive bacteria;2.Gram-positive bacteria is givenpriority to with staphylococcus epidermidis,Gram-negative bacteria isgiven priority to with enterogenous bacteria;3.When blood serumalbumin<29.1g/L, serum phosphate<1.795mmol/L, the tendency for PDrelated peritonitis is easy;4. Intestinal disorders is a risk factor forperitonitis;5.The use of oral Calcitriol was associated with a significantlydecreased risk for peritonitis.