Early Peritonitis in a Large Peritoneal Dialysis Provider System in Colombia.
♦ BACKGROUND: Peritonitis is the most important complication of peritoneal dialysis (PD), and early peritonitis rate is predictive of the subsequent course on PD. Our aim was to calculate the early peritonitis rate and to identify characteristics and predisposing factors in a large nationwide PD provider network in Colombia. ♦ METHODS: This was a historical observational cohort study of all adult patients starting PD between January 1, 2012, and December 31, 2013, in 49 renal facilities in the Renal Therapy Services in Colombia. We studied the peritonitis rate in the first 90 days of treatment, its causative micro-organisms, its predictors and its variation with time on PD and between individual facilities. ♦ RESULTS: A total of 3,525 patients initiated PD, with 176 episodes of peritonitis during 752 patient-years of follow-up for a rate of 0.23 episodes per patient year equivalent to 1 every 52 months. In 41 of 49 units, the rate was better than 1 per 33 months, and in 45, it was better than 1 per 24 months. Peritonitis rates did not differ with age, ethnicity, socioeconomic status, or PD modality. We identified high incidence risk periods at 2 to 5 weeks after initiation of PD and again at 10 to 12 weeks. ♦ CONCLUSION: An excellent peritonitis rate was achieved across a large nationwide network. This occurred in the context of high nationwide PD utilization and despite high rates of socioeconomic deprivation. We propose that a key factor in achieving this was a standardized approach to management of patients.
Renal Therapy Services RTS, Bogotá, D.C. Colombia edgar_vargas@baxter.com.
Edgar
E
Vargas
London Health Sciences Centre and Western University, London, ON, Canada.
Peter G
PG
Blake
Renal Therapy Services RTS Latin America, Bogotá, D.C. Colombia.
Mauricio
M
Sanabria
Renal Therapy Services RTS Latin America, Bogotá, D.C. Colombia.
Alfonso
A
Bunch
Renal Therapy Services RTS, Bogotá, D.C. Colombia.
Patricia
P
López
Renal Therapy Services RTS, Bogotá, D.C. Colombia.
Jasmín
J
Vesga
Renal Therapy Services RTS, Bogotá, D.C. Colombia.
Alberto
A
Buitrago
Renal Therapy Services RTS, Bogotá, D.C. Colombia.
Kindar
K
Astudillo
Renal Therapy Services RTS, Bogotá, D.C. Colombia.
Martha
M
Devia
Universidad Nacional de Colombia, Bogotá, D.C. Colombia.
Ricardo
R
Sánchez
D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003105:Colombia / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D006282:Health Personnel / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D010538:Peritonitis / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012737:Sex Factors; D015996:Survival Rate
Colombia; Peritoneal dialysis; peritonitis