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Epidemiology and outcomes of peritonitis in children on peritoneal dialysis in Australasia

Pediatric Nephrology volume 25, pages 1739–1745 (2010)Cite this article

Abstract

Peritonitis is a common complication and major cause of morbidity in children on peritoneal dialysis. In this retrospective longitudinal study, we analysed data retrieved from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) on 167 patients aged less than 18 years of age who were treated with peritoneal dialysis during the period from October 2003 to December 2007. During this period there were 100 episodes of peritonitis in 57 patients (0.71 episodes/patient-year), with Gram-positive organisms most commonly isolated (44%). Peritonitis occurred frequently in the first 6 months after starting dialysis, with survival analysis showing peritonitis-free survival rates of 72%, 56% and 36% at 6 months, 1 year and 2 years respectively. Age was a weak predictor of peritonitis on univariate analysis, but previous peritonitis was the only significant predictor in a multivariate Cox proportional hazards model (adjusted hazard ratio 2.02; 95% CI: 1.20 to 3.40, p = 0.008). Peritonitis episodes infrequently resulted in relapse (5%), recurrence (7%) or the need for either temporary or permanent haemodialysis (5% and 7% respectively) and there were no patient deaths directly attributable to peritonitis. Compared with single organism peritonitis, polymicrobial peritonitis was not associated with any statistically significant differences in outcome. Further prospective studies are required to determine the most appropriate prophylactic measures and antibiotic regimens for use in pediatric patients.

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Acknowledgements

The authors gratefully acknowledge the substantial contributions of the entire Australia and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators and patients) in providing information for and maintaining the ANZDATA Registry database. Dr. Bordador is supported by an International Society of Nephrology Fellowship.

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Affiliations

  1. Queensland Child and Adolescent Renal Service, Royal Children’s Hospital and Mater Children’s Hospitals, Herston Road, 4029, Herston, Brisbane, Queensland, Australia

    Esmeralda B. Bordador, John R. Burke & Steven J. McTaggart

  2. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia

    David W. Johnson & John R. Burke

  3. University of Queensland, Brisbane, Australia

    David W. Johnson & Steven J. McTaggart

  4. Department of Nephrology, Women’s and Children’s Hospital, Adelaide, Australia

    Paul Henning

  5. Department of Nephrology, Sydney Children’s Hospital, Sydney, Australia

    Sean E. Kennedy

  6. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, Australia

    Stephen P. McDonald

  7. Department of Nephrology & Transplantation Services, University of Adelaide at the Queen Elizabeth Hospital, Adelaide, Australia

    Stephen P. McDonald

Authors
  1. Esmeralda B. Bordador
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  2. David W. Johnson
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  3. Paul Henning
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  4. Sean E. Kennedy
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  5. Stephen P. McDonald
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  6. John R. Burke
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  7. Steven J. McTaggart
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On behalf of the Australian and New Zealand Dialysis and Transplant Registry

Corresponding author

Correspondence to Steven J. McTaggart.

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Bordador, E.B., Johnson, D.W., Henning, P. et al. Epidemiology and outcomes of peritonitis in children on peritoneal dialysis in Australasia. Pediatr Nephrol 25, 1739–1745 (2010). https://doi.org/10.1007/s00467-010-1510-5

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  • DOI: https://doi.org/10.1007/s00467-010-1510-5

Keywords

  • Pediatrics
  • Peritoneal dialysis
  • Peritonitis
  • ANZDATA