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Impacto de las peritonitis en la supervivencia a largo plazo de los pacientes en diálisis peritoneal

Keywords: peritoneal dialysis, peritonitis, survival analysis, technique survival.

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Abstract:

background: the impact of each episode of peritonitis on long-term survival of peritoneal dialysis (pd) patients has yet to be defined. objectives: to determine the risk that each episode of peritonitis poses for patient survival and for the pd technique. patients: 1515 patients included in the levante registry from 1 january 1993 to 31 december 2005. methods: retrospective analysis of a multicentre registry using cox regression for time-dependent variables. results: we analysed 1609 episodes of peritonitis in 716 patients (47.2%). in the univariate analysis, each case of peritonitis treated in the outpatient unit was associated with an increase in mortality (hazard ratio [hr] 1.99, p<.001), which was greater for episodes that required hospitalisation (hr 3.62, p<.001). mortality increased with each successive episode in the same patient. multivariate analysis confirmed the association of each case of peritonitis with lower long-term survival (hr 2.01, p<.001), with a different risk for episodes due to gram-positive and gram-negative bacteria and fungi (hr 1.73, 2.43 and 5.71, respectively; p<.001). other variables associated with mortality were age, low residual renal function, absence of vascular access and comorbidity. peritonitis was the only independent variable associated with technique failure (hr 1.29, p<.001), with a different risk for episodes due to gram-positive and gram-negative bacteria and fungi (hr 1.73, 2.43 and 5.71, respectively; p<.001). conclusions: episodes of peritonitis negatively influence long-term survival of patients on pd.

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