[Effect of peritonitis frequency on the effectiveness of peritoneal dialysis and effect of peritoneal dialysis effectiveness on the frequency of peritonitis].

UNLABELLED: Peritonitis is the most serious complication of peritoneal dialysis treatment for ESRD. There is no unanimous attitude yet concerning the influence of PD adequacy on the frequency of peritonitis. PATIENTS: The paper reports on a study of interrelation of peritonitis frequency and PD adequacy in 61 patients (27 women, 34 men) during a 5-year period. The group included 88% of all PD patients (61 of totally 69). RESULTS AND DISCUSSION: The patients experienced a total of 71 peritonitis episodes over a total of 1615 months of PD treatment. There was one peritonitis episode per 23 months of treatment on an average. When a patient who experienced 11 peritonitis episodes was excluded, the average frequency of peritonitis turned to one in 26 months. Peritonitis frequency and PD adequacy showed a significant negative correlation (r = 0.25, p < 0.05). PD adequacy expressed as total weekly Kt/V did not differ between the patients with and those without a history of peritonitis (Kt/V+ = 1.87 +/- 0.21, Kt/V- = 1.88 +/- 0.24; t = 0.17, p > 0.05). The frequency of peritonitis in men was twofold that in women, i.e. one peritonitis in every 17.24 +/- 11.67 months of treatment in men, and one peritonitis in every 37.81 +/- 13.11 months in women. The difference was statistically significant (t = 6.39, p < 0.01). However, PD adequacy did not differ between men and women (Kt/V = 1.84 +/- 0.21: 1.92 +/- 0.23, t = 1.40, p > 0.05). Patients with more adequate dialysis (n = 51) (Kt/V = 1.70) had one peritonitis in every 23.16 +/- 20.07 months on an average, and those with less adequate dialysis one peritonitis in 21.82 +/- 18.12 months of treatment. The difference was not statistically significant (t = 0.21, p > 0.05). The patients in whom PD was the first method of ESRD treatment (n = 55) experienced one peritonitis in every 24.04 +/- 12.51 months of treatment on an average, and those in whom PD was the second method of ESRD treatment (n = 6) had one peritonitis in 15.68 +/- 13.54 months of treatment. The difference was not significant (t = 1.45, p > 0.05). The difference in dialysis adequacy between these two groups was not significant either, even though the patients with PD as the first method had more adequate dialysis (1.88 +/- 0.22: 1.83 +/- 0.27; t = 0.44, p > 0.05). CONCLUSION: Peritonitis frequency and PD adequacy are significantly negatively correlated. The patients with higher peritonitis frequency had less adequate dialysis, while the patients with less adequate dialysis had peritonitis more frequently. However, the patients with a history of peritonitis had not significantly less adequate dialysis, nor the patients with less adequate dialysis had a significantly higher frequency of peritonitis.