Epidemiology and outcomes of peritonitis in children on peritoneal dialysis in Australasia

Esmeralda B. Bordador, David W. Johnson, Paul Henning, Sean E. Kennedy, Stephen McDonald, John R. Burke, Steven J. McTaggart

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

Peritonitis is a common complication and major cause of morbidity in children on peritoneal dialysis. In this retrospective longitudinal study, we analysed data retrieved from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) on 167 patients aged less than 18 years of age who were treated with peritoneal dialysis during the period from October 2003 to December 2007. During this period there were 100 episodes of peritonitis in 57 patients (0.71 episodes/patient-year), with Gram-positive organisms most commonly isolated (44%). Peritonitis occurred frequently in the first 6 months after starting dialysis, with survival analysis showing peritonitis-free survival rates of 72%, 56% and 36% at 6 months, 1 year and 2 years respectively. Age was a weak predictor of peritonitis on univariate analysis, but previous peritonitis was the only significant predictor in a multivariate Cox proportional hazards model (adjusted hazard ratio 2.02; 95% CI: 1.20 to 3.40, p∈=∈0.008). Peritonitis episodes infrequently resulted in relapse (5%), recurrence (7%) or the need for either temporary or permanent haemodialysis (5% and 7% respectively) and there were no patient deaths directly attributable to peritonitis. Compared with single organism peritonitis, polymicrobial peritonitis was not associated with any statistically significant differences in outcome. Further prospective studies are required to determine the most appropriate prophylactic measures and antibiotic regimens for use in pediatric patients.

Original languageEnglish
Pages (from-to)1739-1745
Number of pages7
JournalPediatric Nephrology
Volume25
Issue number9
DOIs
Publication statusPublished or Issued - Sept 2010

Keywords

  • ANZDATA
  • Pediatrics
  • Peritoneal dialysis
  • Peritonitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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