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KMID : 0359920100290030357
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Korean Journal of Nephrology
2010 Volume.29 No. 3 p.357 ~ p.365
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Risk Factors of Catheter Loss Following Peritonitis in Patients on Continuous Ambulatory Peritoneal Dialysis
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Jang Mi-Hyun
Hong Yoon-Soo
Kim Jung-Eun
Hwang Eun-Ah
Han Seung-Yeup
Park Sung-Bae
Kim Hyun-Chul
Lee Kum-Hee
Choi Go
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Abstract
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Purpose : Peritoneal dialysis (PD) catheter removal is regarded as an important index of patient morbidity.The aim of this study was to evaluate factors influencing catheter loss following peritonitis in PD patients.
Methods : We retrospectively reviewed 917 episodes of peritonitis in 621 new CAPD patients from Jan 2001 to Feb. 2009 in Dongsan Medical center. Episodes requiring PD catheter removal were compared by both univariate and ultivariate analyses with those in which PD catheters were preserved.
Results : When peritonitis episodes requiring PD catheter removal (n=80) were compared to catheter preserved peritonitis episodes (n=837), the incidence of PD catheter loss increased as the duration on PD preceding the peritonitis were longer (p<0.000). Also, PD catheter removal was more likely to occur after peritonitis episodes with low serum albumin level (p=0.009) and high serum CRP level (p<0.000), those with long duration of PD effluent leukocyte count doaining above 100/mm3 (p<0.000), those with concomitant exit site/tunnel infection (p=0.043), and those with presence of abdominal pathology(p<0.000). The microbiological determinants of PD catheter loss included two or more bacteria cultured (p=0.002) and fungi (p<0.000). In multivariate analysis, the duration of PD effluent leukocyte count remaining above 100/mL and the number of organism cultured were independent risk factors of PD catheter removal in peritonitis episodes.
Conclusion : Duration of PD effluent leukocyte count remaining above 100/mm3, and the number of organisms cultured were independent risk factors for catheter removal following peritonitis.
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KEYWORD
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Peritoneal dialysis, Peritonitis, Device removal
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