Peritoneal Dialysis–Related Peritonitis: Towards Improving Evidence, Practices, and Outcomes

• Published in: American journal of kidney diseases Vol. 64; no. 2; pp. 278 - 289
• Main Authors: Cho, Yeoungjee, Johnson, David W.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2014; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibiotics; bacteria; Biological and medical sciences; Emergency and intensive care: renal failure. Dialysis management; fungi; Humans; Intensive care medicine; Medical sciences; microbiology; Nephrology; Nephrology. Urinary tract diseases; outcomes; peritoneal dialysis; Peritoneal Dialysis - adverse effects; Peritoneal Dialysis - trends; peritonitis; Peritonitis - diagnosis; Peritonitis - etiology; Peritonitis - prevention & control; practice variation; prevention; quality improvement; Risk Factors; Treatment Outcome; risk factors; practice variation; Antibiotics; bacteria; fungi; outcomes; peritonitis; quality improvement; microbiology; peritoneal dialysis; prevention; Nephrology; Prognosis; Microbiology; Variations; Epidemiology; Peritoneal dialysis; Urology; Fungi; Prevention; Extrarenal dialysis; Antibiotic; Abdominal disease; Quality; Risk factor; Bacteria; Antibacterial agent; Peritonitis
• ISSN: 0272-6386; 1523-6838; 1523-6838
• DOI: 10.1053/j.ajkd.2014.02.025

Peritonitis is a common serious complication of peritoneal dialysis that results in considerable morbidity, mortality, and health care costs. It also significantly limits the use of this important dialysis modality. Despite its importance as a patient safety issue, peritonitis practices and outcomes vary markedly and unacceptably among different centers, regions, and countries. This article reviews peritonitis risk factors, diagnosis, treatment, and prevention, particularly focusing on potential drivers of variable practices and outcomes, controversial or unresolved areas, and promising avenues warranting further research. Potential strategies for augmenting the existing limited evidence base and reducing the gap between evidence-based best practice and actual practice also are discussed.