Predictors of culture-negative peritoneal dialysis-associated peritonitis: a single center, retrospective study

Renal Replacement Therapy

Research

Takuji Ohara¹  Seiichiro Wariishi²  Hiroyuki Azuma³  Kazuyoshi Okada⁴  Hisato Shima⁴  Manabu Tashiro⁴  Jun Minakuchi⁴  Tomoko Inoue⁴  Toshio Doi⁴  Takuya Okamoto⁵  Hiroyasu Bando⁶  Naohito Iwasaka⁷ 

[1] Anan Kawashima Clinic, 80-1 Kandaizi, Iwawaki, Hanoura-cho, 779-1106, Anan, Japan;Department of Cardiovascular Surgery, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, 770-0011, Tokushima, Japan;Department of Internal Medicine, Kawashima Hospital, 6-1 Kitasakoichiban-cho, 770-0011, Tokushima, Japan;Department of Kidney Disease, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, 770-0011, Tokushima, Tokushima, Japan;Department of Laboratory, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, 770-0011, Tokushima, Tokushima, Japan;Department of Respiratory Medicine, Kawashima Hospital, 6-1 Kitasakoichiban-cho, 770-0011, Tokushima, Japan;Kawashima Dialysis Clinic, 1-8 Kitasakoichiban-cho, 770-0011, Tokushima, Japan;

关键词: Culture-negative peritonitis;    Peritoneal dialysis;    Gender;    Dialysate cell counts;    β-microglobulin;   

DOI  :  10.1186/s41100-023-00498-9

 received in 2023-06-02, accepted in 2023-08-20,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEmpirical antibiotic treatment against peritoneal dialysis (PD)-related peritonitis should be immediately initiated before PD effluent culture results are obtained. As culture results guide the choice of antibiotics, culture-negative peritonitis (CNP) is a serious issue. In addition, the identification of the causative organism often indicates a possible source of infection. This study aimed to clarify the predictors of CNP.MethodsThis single-center, retrospective study was conducted from November 2007–December 2018 in patients undergoing PD with peritonitis at our institution, where 204 peritonitis episodes (57 culture-negative, 147 culture-positive) were investigated based on demographics, and clinical parameters. CNP predictors were investigated using logistic regression.ResultsCNP rate was significantly higher in female and in patients with higher platelet counts, lower dialysate cell counts at peritonitis diagnosis, and higher serum β2-microglobulin levels. In multivariate logistic regression, female sex (odds ratio [OR] 2.69, 95% confidence interval [CI] 1.31–5.54), dialysate cell count at diagnosis (OR0.99, 95% CI 0.99–0.99), and serum β2-microglobulin level (OR 1.04, 95% CI 1.00–1.07) were significantly associated with CNP. The areas under the receiver operating characteristic curve for female patients, dialysate cell counts at diagnosis of peritonitis, serum β2-microglobulin level, and female patients + dialysate cell counts at diagnosis of peritonitis + serum β2-microglobulin level were 0.604, 0.694, 0.603, and 0.751, respectively.ConclusionsFemale sex, dialysate cell counts at peritonitis diagnosis, and serum β2-microglobulin levels may be predictors of CNP.

【 授权许可】

CC BY   
© The Japanese Society for Dialysis Therapy and BioMed Central Ltd. 2023

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