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Frequency and prognosis of peritoneal dialysis-associated peritonitis in children

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Abstract

Background

Peritonitis is the leading cause of peritoneal dialysis (PD) discontinuation. However, few data concern risk factors of peritonitis development and catheter removal caused by treatment failure in pediatric patients.

Methods

This single-center, retrospective study analyzed data from pediatric patients who underwent chronic PD between March 2002 and June 2022. The incidence rates of peritonitis by the person-year method were calculated, and they were stratified by patient age groups. Risk factors for peritonitis development and catheter removal were also analyzed by multivariate analysis using logistic regression model.

Results

Ninety patients were enrolled, and 62 peritonitis episodes were observed in 41 (46%) patients. The incidence rate of peritonitis was 0.21 episodes per patient-year, which was the highest in children aged under 2 years old (0.26 episodes per patient-year). Moreover, 44 (71%) cases were successfully cured by antibiotics alone, although 17 (27%) cases required catheter removal, and 4 (6%) cases transitioned to chronic hemodialysis because of peritoneal dysfunction. One patient died. The risk factor for peritonitis development and catheter removal caused by treatment failure was PD insertion at under 2 years old (odds ratio = 2.5; P = 0.04) and Pseudomonas aeruginosa (odds ratio = 11.0; P = 0.04) in the multivariate analysis. P. aeruginosa was also a risk factor for difficulty in re-initiating PD (P = 0.004).

Conclusions

The incidence rate of peritonitis was the highest in children under 2 years old. P. aeruginosa peritonitis is a risk factor for catheter removal and peritoneal dysfunction.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available because permission for their publication was not obtained from the participants or approved by the ethics committee. However, they are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Enago Crimson Interactive Pvt. Ltd. for English proofreading and editing a draft of this manuscript.

Funding

The authors did not receive any external funding for this study.

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Authors and Affiliations

  1. Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan

    Misaki Akiyama, Koichi Kamei, Kentaro Nishi, Tomoya Kaneda, Yuta Inoki, Kei Osaka, Mai Sato, Masao Ogura & Shuichi Ito

  2. Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan

    Misaki Akiyama & Shuichi Ito

Authors
  1. Misaki Akiyama
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  2. Koichi Kamei
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  3. Kentaro Nishi
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  4. Tomoya Kaneda
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  5. Yuta Inoki
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  6. Kei Osaka
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  7. Mai Sato
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  8. Masao Ogura
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Contributions

All authors were physicians treating the patients in this report. Misaki Akiyama prepared the manuscript and performed data collection and analysis. Kentaro Nishi, Mai Sato, and Masao Ogura edited and reviewed the manuscript. Shuichi Ito revised the manuscript. Koichi Kamei oversaw the work as the corresponding author and revised the manuscript. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Koichi Kamei.

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Conflict of interests

Koichi Kamei has received research funding from the Public Foundation of Vaccination Research Center, and the Taiju Life Social Welfare Foundation; donations from Chugai Pharmaceutical Co. Ltd., Teijin Pharma Ltd., Kyowa Kirin Co. Ltd., Shionogi & Co. Ltd., Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma Co. Ltd, and Otsuka Pharmaceutical Co. Ltd.; and lecture fees from Terumo Co. Ltd., Baxter Ltd., and Zenyaku Kogyo Co., Ltd. Shuichi Ito has received research funding from Zenyaku Kogyo Co., Ltd., and Teijin Pharma Ltd.; and honoraria from Astrazeneca PLC and Alexion Pharmaceuticals Inc.

Ethics approval

This study was approved by the Ethics Committee of the National Center for Child Health and Development (Approval no. 2022–169).

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Akiyama, M., Kamei, K., Nishi, K. et al. Frequency and prognosis of peritoneal dialysis-associated peritonitis in children. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02482-x

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  • DOI: https://doi.org/10.1007/s10157-024-02482-x

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