Meza PMJ, García LE, Mendoza GL, Miranda NMG, Solórzano SF

Language: Spanish
References: 23
Page: 45-51
PDF size: 147.15 Kb.

ABSTRACT

Objective. To identify risk factors for recurrent peritonitis in children with chronic renal failure under continuos ambulatory peritoneal dialysis.
Materials y methods. Retrospective cohort study of children with crhonic renal failure Ander continuos ambulatory peritoneal diálisis attending the Hospital de pediatría Centro Médico Nacional Siglo XXI during 6 years. We studied three groups of patients: I) patients with peritonitis, II) patients with recurrent peritonitis, III) patients without peritonitis. We registered the following information age, sex, socioeconomic level, nutritional state, anemia and hypoproteinemia, time to catheter removal, type of system of dialysis and number of catheter removals. Statistical analysis for risk factor was done by Mantel–Haenszel test, odds ratio and 95% confidence intervals.
Results. From January 1990 to December 1996 we studied 145 children with chronic renal failure treated with continuos ambulatory peritoneal diálisis, 67 (46.2%) were male, 78 (53.7%) were female, ratio male/female 1:1.1. 44.0% were 13 to16 years old. 78.6% developed peritonitis from them 57.2% developed recurrent peritonitis. Risk factors for recurrent peritonitis were low socioeconomic level, anemia, diálisis with traditional peritoneal dialysis system and II and III malnutrition degree.
Conclusions. In this study we were able to identify some modifying risk factors for recurrent peritonitis in children under peritoneal dialysis, such as malnutrition, anemia and type of dialysis system. If we work on them we can modify frequency of recurrent peritonitis.

REFERENCES

1. Maiorca R, Cantaluppii A, Cancarini GC et al. Prospective controlled trial of a Y-connector and disinfectant to prevent peritonitis in continuous ambulatory peritoneal dialysis. Lancet 1983; 17; 2(8351): 642-644

2. Boeschoten E, Boen F. Peritonitis en DPCA. Nefrología Mexicana 1991; 12: 59-67

3. Treviño A. Factores de éxito de la diálisis peritoneal. Nefrología Mexicana 1990; 11: 3-6

4. Vas S. Microbiologic aspects of chronic ambulatory peritoneal dialysis. Kidney Int 1983; 23: 83-92

5. Tranaeus A, Hemburger O, Lindholm B. Peritonitis during continuous ambulatory peritoneal dialysis, risk factors, clinical severity and pathogenic aspects. Perit Dial Int 1988 ;8: 253-263

6. Prowant B, Nolph K, Ryan I, Russeet L. Peritonitis in continuous ambulatory dialysis. Clinical Nephrol 1993; 39: 70-74

7. Dombros N, Digenis E, Balaskas V, Bias N. Long-term continuous ambulatory peritoneal dialysis. Nephrol 1986; 43: 105-109

8. Shwartz R. Chronic peritoneal dialysis: Mechanisms and infectious complications. Nephrol 1985; 40: 29-37

9. 9.- Echweinburg F, Seligman A, Fine J. Transmural migration of intestinal bacteria. N Eng J Med 1960; 242: 742-751

10. Parrot P. Pseudomonas aeruginosa associated with contaminated poloxamer-iodin solution. Lancet 1982; 2: 635-655

11. Vargas R. Diálisis peritoneal con catéter Tenckhoff. Bol Med Hosp. Infant 1984; 41: 545-551

12. Torres Z, García M, Chávez B, Méndez J. Diálisis peritoneal ambulatoria continua para el tratamiento de la insuficiencia renal crónica. Rev Med IMSS 1986; 21: 336-341

13. Keane W, Everet E, Fine R, Rya F. Continuous ambulatory peritoneal dialysis-related poeritonitis. Perit Dial Int 1989; 9: 247-256

14. Treviño A, García E, Mendoza L. Un grupo de pacientes en DPCA visita a un nuevo grupo. Nefrología Mexicana1989; 10: 61-63

15. Ramírez M. La diálisis peritoneal continua ambulatoria en 159 pacientes con IRC. Nefrología Mexicana 1991; 12: 145-155

16. Spencer RC. Infections in continuous ambulatory peritoneal dialysis. J Med Microbiol 1988; 27: 1-9

17. Cheng T. Peritonitis fungeal in continuous ambulatory peritoneal dialysis. Nephrol 1990; 20: 350-556

18. García E, Mendoza L, Morales A, Ortiz O. Comparison of peritonitis rates in children on CAPD with spike connector versus two disconeect systems. Adv Perit Dial 1994; 10: 300-303

19. Monteon F, García G, Mejía G. El sistema de desconexión y-set en el manejo de pacientes con DPCA. Nefrología Mexicana 1992; 13: 89-90

20. Buoncristiani U, Bianchi P, Nasimi M, Parlani F, Covarelli C, Buoncristiani E, Bastianini L, Bistoni F. In vitro study of the efficacy of a two-way connection with disinfectant in the prevention of peritonitis. Adv Perit Dial 2000;16: 208-212

21. Jacob V, Marchant P, Wild G. Nutritional profile of continuous ambulatory peritoneal dialysis patients. Nephrol 1995; 71: 16-22

22. Chow KM, Szeto CC, Leung CB, Kwan BC, Law MC, Li PK. A risk analysis of continuous ambulatory peritoneal dialysis- related peritonitis. Perit Dial Int 2005; 25(4): 374-379

23. Gutman R. Characteristics of long-term survivors of maintenance dialysis. Nephrol 1983; 3: 111-115