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Peritonitis is a common and serious complication of peritoneal dialysis (PD). Although in some cases, the cavity can be preserved with targeted antibiotic management, the risk of catheter repositioning or loss of the peritoneal cavity is high.
Retrospective observational cohort study that included 167 patients with the insertion of a Tenckhoff catheter for urgent dialysis and urgent-start dialysis. Clinical and biochemical data of the patients were collected. Patients were categorized based on whether they had experienced PACDP. The variables were expressed as mean ± standard deviation, median (interquartile range), or number of subjects (%). Comparison of means among the four groups was performed using T-Student, Mann-Whitney U, or chi-squared tests, respectively. A Cox regression was used to determine factors associated with PACDP
Of the total patients, 41.9% were female, the mean age was 54.6 ± 13.8 years, a body mass index (BMI) of 26.2 ± 4.9 kg/m2, 72.3% had diabetes, 76.8% had hypertension, 25.8% had a history of open abdominal surgery, 18.7% of the catheters were placed by general surgery, and 81.3% by interventional nephrology. In total, 10.3% of patients experienced PACDP (placed by interventional nephrology 6.3%, placed by general surgery 27.6%; p=0.001). Cox regression showed that a history of abdominal surgery [HR= 4.527 (95% CI 1.213 – 16.896)], a catheter opening time exceeding 12 hours [HR= 5.154 (95% CI 1.127 - 23.5665)], and higher BMI [HR= 1.246 (95% CI 1.081 - 1.437)] were independently associated with a higher risk of PDAP. Although age [HR= 0.968 (95% CI 0.933 – 1.005)] and lower serum albumin at admission [HR= 3.149 (95% CI 0.972 - 10.199)] entered the multivariate analysis, they did not reach statistical significance.
In our cohort of patients with PD catheter insertion, it was demonstrated that risk factors for PACDP were a history of abdominal surgery, catheter opening time, and BMI.