Assessment of potential peritonitis risk factors in pediatric patients receiving maintenance peritoneal dialysis

On Behalf Of the Standardizing Care to Improve Outcomes in Pediatric End-stage Kidney Disease (SCOPE) Investigators

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Many recommendations regarding peritonitis prevention in international consensus guidelines are opinion-based rather than evidence-based. The aim of this study was to examine the impact of peritoneal dialysis (PD) catheter insertion technique, timing of gastrostomy placement, and use of prophylactic antibiotics prior to dental, gastrointestinal, and genitourinary procedures on the risk of peritonitis in pediatric patients on PD. Methods: We conducted a retrospective cohort study of pediatric patients on maintenance PD using data from the SCOPE collaborative from 2011 to 2022. Data pertaining to laparoscopic PD catheter insertion (vs. open), gastrostomy placement after PD catheter insertion (vs. before/concurrent), and no prophylactic antibiotics (vs. yes) were obtained. Multivariable generalized linear mixed modeling was used to assess the relationship between each exposure and occurrence of peritonitis. Results: There was no significant association between PD catheter insertion technique and development of peritonitis (aOR = 2.50, 95% CI 0.64–9.80, p = 0.19). Patients who had a gastrostomy placed after PD catheter insertion had higher rates of peritonitis, but the difference was not statistically significant (aOR = 3.19, 95% CI 0.90–11.28, p = 0.07). Most patients received prophylactic antibiotics prior to procedures, but there was no significant association between prophylactic antibiotic use and peritonitis (aOR = 1.74, 95% CI 0.23–13.11, p = 0.59). Conclusions: PD catheter insertion technique does not appear to have a significant impact on peritonitis risk. Timing of gastrostomy placement may have some impact on peritonitis risk. Further study must be done to clarify the effect of prophylactic antibiotics on peritonitis risk. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish (US)
Pages (from-to)4119-4125
Number of pages7
JournalPediatric Nephrology
Volume38
Issue number12
DOIs
StatePublished - Dec 2023

Keywords

  • Children
  • Peritoneal dialysis
  • Peritonitis

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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