Work

Outcome of Peritonitis in Automated Peritoneal Dialysis: A Cohort Study

Year: 2025

Type: article

Abstract: Rational & Objectives Peritonitis is a serious complication of peritoneal dialysis (PD). Current treatment guidelines are directed towards patients receiving continuous ambulatory PD (CAPD), whilst the optimal treatment for automated PD (APD) is less clear. In this study, we compared the bacteriology and treatment outcomes of peritonitis episodes between APD and CAPD patients and, for peritonitis episodes in APD patients, we studied the difference in clinical outcomes between intermittent and continuous dosing of intraperitoneal antibiotics. Study Design: This is a single-center, retrospective cohort study. Setting & Participants 176 APD peritonitis episodes from 2007 to 2021 were compared to 352 CAPD episodes, matched for age, sex, and diabetes status. Exposures Mode of PD; intermittent versus continuous dosing of intraperitoneal antibiotics. Outcomes: Primary outcome was the rate of complete cure. Analytical Approach Groups were compared by Chi-squared test, Mann-Whitney U test, Student's t-test, or Fisher's exact test. Results The APD group had higher complete cure rates than CAPD group (88% vs 81%, p=0.033), but primary response rates were similar. NIPD patients had significantly higher primary response rates (91% vs 80%, p=0.03) and complete cure rates (95% vs 79%, p < 0.001) than CCPD. Within APD, those treated with intermittent dosing of intraperitoneal antibiotics demonstrated significantly better primary response rates (91% vs 69%, p < 0.001) and complete cure rates (93% vs 74%, p <0.001) than those converted to CAPD for a continuous regimen. Limitations: Retrospective study; small subgroup size. Conclusions Peritonitis episodes in APD had better treatment outcomes than CAPD. In the APD group, treatment with intermittent dosing of intraperitoneal antibiotics had better primary response rate and complete cure rate than those treated with continuous regimens.

Source: Kidney Medicine

DOI: 10.1016/j.xkme.2025.101153