Peritonites em um centro de diálise peritoneal: experiência de 10 anos

Abstract

Introduction: Peritonitis remains as the main Peritoneal Dialysis (PD)-related complication. Objective: Evaluate episodes of PD-related peritonitis and describe its incidence, causative organisms and possible predictors in patients belonging to a DP program from a reference center. Methods: Retrospective cohort study that evaluated 565 patients who stayed for at least 30 days in technique, between 01/01/2003 and 12/31/2012. Data of patients with or without peritonitis were compared using chi-square test and Mann-Whitney test. Results: Most patients (59%) showed no peritonitis. The global index was 0,32 episode per year at risk. It was recorded the lowest rate in 2012 (0,26 episode per year), coinciding with the introduction, since 2011, of daily use of gentamicin in peritoneal catheter exit site. Staphylococcus aureus was the most prevalent germ (23%). There was healing of peritonitis in 71% of cases. It identified a higher risk of peritonitis in patients with history of exit site infection (relative risk = 1.24; 95% confidence interval = 1.02 - 1.50; p <0.05). There was no significant difference between groups, with or without peritonitis, in terms of sociodemographic factors. Conclusions: Despite bad social indicators of studied population, the incidence of peritonitis follows recommendations of the International Society for Peritoneal Dialysis (ISPD), with a reduction of rates along the years, especially after introduction of gentamicin. Similar as described by other authors, exit site infection was recognized as a peritonitis´ predictor, so it is extremely important to perform preventive strategies.