Factors affecting peritoneal infection in peritoneal dialysis patients at Aranyaprathet Hospital

Abstract

Introduction

Currently, chronic kidney disease is considered an important public health problem in Thailand. The most common complication in patients undergoing peritoneal dialysis is infection in the peritoneum causing the abdominal wall to deteriorate and resulting in fluid retention and swelling. Therefore, it is important to find the cause of the peritoneal infection. To prevent infection in the peritoneum in peritoneal dialysis patients, makes the abdominal wall last longer and reduce hospital stays.

Objectives

To explain the prevalence and study risk factors that cause intraperitoneal infections in peritoneal dialysis patients at Aranyaprathet Hospital.

Methods

The population consisted of end-stage renal disease patients receiving peritoneal dialysis and received follow-up treatment at Aranyaprathet Hospital for at least 3 months from 1 January 2020 to 31 December 2023 total of 36 patients.

Results

A total of 36 patients with end-stage renal disease receiving peritoneal dialysis were divided into 22 patients with infected continuous ambulatory peritoneal dialysis (CAPD) and 14 patients without infected CAPD. Patients with infected CAPD the median age was 58 years, 54.5 percent were men, 50% had diabetes mellitus (DM), and the median body mass index (BMI) was 25.3 kg/m². From baseline characteristic for both groups, it was found that the group with infected CAPD used omeprazole significantly more than the group without infected CAPD (56% and 14%, respectively). Multivariate analysis results, it was found that potassium is a factor affecting infection, Patients with potassium levels less than 3.0 mmol per liter (moderate or severe hypokalemia) having an 11.7 times chance of infection [aOR: 11.67 (95%CI : 1.26-107.7)]. As for blood phosphorus, albumin, BMI and DM is not a risk factor that affects peritoneal infection. The culture results from the dialysis fluid showed that there were infections in a total of 13 cases (59 percent). The pathogens that were the most common cause were Staphylococcus aureus was found in 3 patients (13.6 percent), followed by Streptococcus salivarius was found in 2 cases (9 percent). The most common symptoms were diarrhea and vomiting, in a total of 7 cases (31.8 percent). Two patients (9.7 percent) had their dialysis method changed from peritoneal to vascular access and 2 deaths (9.1 percent)

Conclusion

Potassium levels are factor affecting infection. Patients with potassium levels less than 3.0 mmol/L there will be a 11.7 times chance of infection. Blood phosphorus, albumin, BMI and DM is not a risk factor that affects peritoneal infection. The pathogens that were the most common cause were Staphylococcus aureus and Streptococcus salivarius respectively.