Analysis of related factors influencing prognosis of patients with peritoneal dialysis-associated peritonitis

Objective To explore the related risk factors affecting the prognosis of patients with peritoneal dialysis-associated peritonitis (PDAP).Methods The basic clinical data, laboratory indicators and outcomes of patients during occurrence of PDAP, who underwent continuous ambulatory peritoneal dialysis (CAPD) at the peritoneal dialysis center of the Affiliated Hospital of Xuzhou Medical University from January 2014 to October 2019, were analyzed retrospectively. According to the prognosis of PDAP patients, they were divided into three groups:cure group, withdrawal (extubation, death) group, and relapse (repeat, recurrence or reappearance of peritonitis after treatment) group. Multiple logistic regression analysis was used to analyze the independent risk factors affecting prognosis.Results A total of 133 peritonitis cases in 78 selected peritoneal dialysis patients included 81 cases in the cured group, 26 cases in the withdrawal group, and 26 cases in the relapse group. Pathogen culture showed 57 cases of Gram-positive bacteria, 39 cases of Gram-negative bacteria, 4 cases of mixed bacterial infections, 6 cases of fungal infections, and 27 cases of negative results. The duration of symptoms of peritonitis in the withdrawal group was longer than that in the cure group and the relapse group (P<0.05). The levels of prealbumin and albumin in the withdrawal group were lower than those in the cured group and the relapse group (P<0.05), and hs-CRP levels were higher than the other two groups (P<0.05). The prealbumin level in the relapse group was lower than that in the cure group (P<0.05), and the serum potassium level in the withdrawal group was lower than that in the cure group (P<0.05). Logistic regression analysis indicated that delayed treatment time, high hs-CRP level and hypoalbuminemia were independent risk factors for withdrawal from peritoneal dialysis in patients with peritoneal dialysis.Conclusions Delayed treatment time, elevated hs-CRP level and hypoalbuminemia may be independent risk factors for withdrawal from peritoneal dialysis in patients with peritoneal dialysis. PDAP patients should enhance nutritional support and early anti-infection treatment, so as to reduce relapse rate, extubation and mortality.