Decreased incidence of peritoneal dialysis-associated peritonitis in young children

Abstract

Abstract Background Peritonitis is the most common complication of peritoneal dialysis (PD). This study aimed to investigate changes in the incidence, risk factors, microbiology, and clinical outcomes of PD-associated peritonitis in the past decades. Methods This was a retrospective study that included children who initiated chronic PD at Seoul National University Children’s Hospital between 2000 and 2017. The patients were divided into two groups according to the year of initiation: those who initiated PD between 2000 and 2008 and those who initiated PD between 2009 and 2017. The follow-up data until PD cessation, death, or June 30, 2023, were reviewed. The incidence and characteristics of peritonitis were compared between the groups. Results A total of 184 patients (107 males and 77 females) with a median age of 10.2 years were included in this study. Of the patients, 92 experienced 210 episodes of peritonitis. Automated PD was the dominant PD modality in the later period. The incidence rate of peritonitis decreased from 0.35 to 0.21 episodes/patient year during the study period (P = 0.001). No changes were observed in the distribution of causative organisms. Subgroup analysis showed an increase in the 2-year peritonitis-free rate from 26.9–93.3% in children under 2 years of age. No significant difference in the 2-year peritonitis-free rate was observed among different age groups since 2009. Conclusions The incidence of PD-associated peritonitis decreased, particularly in children under 2 years of age. Thus, younger age is no longer a risk factor for PD-associated peritonitis.