Preditores de peritonite em pacientes em um programa de diálise peritoneal
Predictor factors of peritoneal dialysis-related peritonitis
João Victor Duarte Lobo1, Keila Ribeiro Villar2, Manoel Pacheco de Andrade Júnior3, Kleyton de Andrade Bastos4
Introduction: Peritonitis remains a major complication of peritoneal dialysis (PD). Objective: Evaluate peritonitis incidence, etiology and outcome in cronic PD patients. Methods: A retrospective cohort study was carried out on 330 patients (mean age of 53±19 years) who had been treated by PD in a dialysis center in Aracaju/SE, Brazil between January 1st, 2003 and December 31th, 2007. Data of patients with and without peritonitis were compared using Student's t-test, chi-squared statistic and multiple logistic regression. Results: There were 213 peritonitis among 141 patients (1.51 episode/patient) resulting in a rate of 28.44 patient/episode/month (0.42 patient/episode/year). Staphylococcus aureus was the most frequent micro-organism isolated (27.8%), followed by Escherichia coli (13.4%) and 32.5% were culture-negative peritonitis. A greater risk of peritonitis was identified at the patients with hypoalbuminemia [relative risk (RR)=2.0; 95% confidence interval (CI)=1.21 - 3.43; p<0,01], < 4 school years (RR=2.15; CI=1.09 - 4.24; p=0.03) and catheter's exit site infection (RR=2.63; IC=1.57 - 4.41; p<0.01). There were no significant difference among gender, age, family income, diabetes mellitus, type of dialysis treatment, type of catheter and its surgical implant. Conclusions: Hypoalbuminemia, low schooling and catheter's exit site infection were associated with greater risk to peritonitis. Although peritonitis rate follow international pattern, prophylactic strategies are recommended.
Descriptors: chronic kidney failure, peritoneal dialysis, peritonitis.