Peritonitis in Thai continuous ambulatory partioneal dialysis patients : an analysis of factors associated with the rate of pritonitis

This research has the objectives to study the various factors affecting the rate of peritonitis in Thai continuous ambulatory peritoneal dialysis patients, and the effect of diabetic, aging, and Staphylococcus infection to the survival and technique survival of dialysis. Historical cohort study in 102 cases of Continuous Ambulatory Peritoneal Dialysis patients was undertaken. The patients received the CAPD treatment since January 1993, in Nephrology unit, Medical Department, Bhumibol Adulyadej Hospital, Bangkok, Thailand. Peritonitis occurred 157 episodes in 70 cases ( 68.6%). The average rate of peritonitis was 1.54 episodes per year per patient. The range varied from 0 to 9 episodes per case. Only 18.5% of peritonitis were culture positive. Pseudomonas species was found to be the most common causes of peritonitis. By Logistic Regression Analysis , low BUN level, high duration, and low education were found to be the risk of peritonitis. In cases who developed peritonitis, high BUN level, high Hb level and high duration were found associated with time to first episode of peritonitis, by Multiple regression analysis. Diabetes mellitus, aging, and Staphylococcus infection did not affect the technique survival. Diabetes mellitus, and aging caused the shorter survival. The majority of the mortality were from the coronary heart disease and cerebrovascular disease. The incidence of Staphylococcus aureus infection was low, and the survival was not different from the cases without infection. In comparison with other infection, S.aureus infection had better survival. From these evidences, the attempt to get rid S. aureus infection by detection the nasal carrier may be not necessary.