Peritoneal dialysis (PD) is a predominant modality of renal replacement therapy (RRT) for individuals suffering from end-stage renal disease (ESRD). Peritoneal dialysis-associated peritonitis (PDAP) represents a frequent complication among patients undergoing PD, significantly contributing to adverse clinical outcomes. This review comprehensively examines the diagnosis, classification, and risk factors associated with PDAP, aiming to offer clinical practitioners essential guidance and a foundational framework for effective clinical management.
Bello AK, Okpechi IG, Levin A, et al., 2023, ISN–Global Kidney Health Atlas: A Report by the International Society of Nephrology: An Assessment of Global Kidney Health Care Status focussing on Capacity, Availability, Accessibility, Affordability and Outcomes of Kidney Disease. International Society of Nephrology, Brussels, Belgium. https://www.theisn.org/wp-content/uploads/media/ISN%20Atlas_2023%20Digital.pdf
Liyanage T, Ninomiya T, Jha V, et al., 2015, Worldwide Access to Treatment for End-Stage Kidney Disease: A Systematic Review. Lancet, 385(9981): 1975–1982. https://doi.org/10.1016/S0140-6736(14)61601-9
Yu X, Yang X, 2015, Peritoneal Dialysis in China: Meeting the Challenge of Chronic Kidney Failure. Am J Kidney Dis, 65(1): 147–151. https://doi.org/10.1053/j.ajkd.2014.08.023
Perl J, Fuller DS, Boudville N, et al., 2020, Optimizing Peritoneal Dialysis-Associated Peritonitis Prevention in the United States: From Standardized Peritoneal Dialysis-Associated Peritonitis Reporting and Beyond. Clin J Am Soc Nephrol, 16(1): 154–161. https://doi.org/10.2215/CJN.11280919
Mehrotra R, Devuyst O, Davies SJ, et al., 2016, The Current State of Peritoneal Dialysis. J Am Soc Nephrol, 27(11): 3238–3252. https://doi.org/10.1681/ASN.2016010112
Himmelfarb J, Vanholder R, Mehrotra R, et al., 2020, The Current and Future Landscape of Dialysis. Nat Rev Nephrol, 16(10): 573–585. https://doi.org/10.1038/s41581-020-0315-4
Li PK, Chow KM, Cho Y, et al., 2022, ISPD Peritonitis Guideline Recommendations: 2022 Update on Prevention and Treatment. Perit Dial Int, 42(2): 110–153. https://doi.org/10.1177/08968608221080586. Erratum in Perit Dial Int, 43(3): 279. https://doi.org/10.1177/08968608231166870. Erratum in Perit Dial Int, 44(3): 223. https://doi.org/10.1177/08968608241251453
Wu H, Ye H, Huang R, et al., 2020, Incidence and Risk Factors of Peritoneal Dialysis-Related Peritonitis in Elderly Patients: A Retrospective Clinical Study. Perit Dial Int, 40(1): 26–33. https://doi.org/10.1177/0896860819879868
Ljungman S, Jensen JE, Paulsen D, et al., 2023, Factors Associated with Time to First Dialysis-Associated Peritonitis Episode: Data from the Peritonitis Prevention Study (PEPS). Perit Dial Int, 43(3): 241–251. https://doi.org/10.1177/08968608231161179
Chung M-C, Yu T-M, Wu M-J, et al., 2022, Impact of Peritoneal Dialysis-Related Peritonitis on PD Discontinuation and Mortality: A Population-Based National Cohort Study. Perit Dial Int, 42(2): 194–203. doi:10.1177/08968608211018949
Marshall MR, 2022, A Systematic Review of Peritoneal Dialysis-Related Peritonitis Rates Over Time from National or Regional Population-Based Registries and Databases. Perit Dial Int, 42(1): 39–47. doi:10.1177/0896860821996096
Perl J, Fuller DS, Bieber BA, et al., 2020, Peritoneal Dialysis-Related Infection Rates and Outcomes: Results From the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). Am J Kidney Dis, 76(1): 42–53. https://doi.org/10.1053/j.ajkd.2019.09.016
Martin LC, Caramori JC, Fernandes N, et al., 2011, Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients. Clin J Am Soc Nephrol, 6(8): 1944–1951. https://doi.org/10.2215/CJN.11431210
Chern YB, Ho PS, Kuo LC, et al., 2013, Lower Education Level is a Major Risk Factor for Peritonitis Incidence in Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study with 12-Year Follow-Up. Perit Dial Int, 33(5): 552–558. https://doi.org/10.3747/pdi.2012.00065
Ueda R, Nakao M, Maruyama Y, et al., 2019, Effect of Diabetes on Incidence of Peritoneal Dialysis-Associated Peritonitis. PLoS One, 14(12): e0225316. https://doi.org/10.1371/journal.pone.0225316
John MM, Gupta A, Sharma RK, et al., 2017, Impact of Residual Renal Function on Clinical Outcome and Quality of Life in Patients on Peritoneal Dialysis. Saudi J Kidney Dis Transpl, 28(1): 30–35. https://doi.org/10.4103/1319-2442.198109
Komatsu S, Hara T, Hiratsuka M, et al., 2021, Association between Conscientiousness and Peritoneal Dialysis-Related Peritonitis. Nephrology (Carlton), 26(12): 999–1006. https://doi.org/10.1111/nep.13952
Hu J, Yi B, Zhang H, 2022, Influence of Climatic Factors on Single-Center Peritoneal Dialysis-Associated Peritonitis. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 47(5): 639–649. https://doi.org/10.11817/j.issn.1672-7347.2022.210506
Zeng Y, Jiang X, Feng S, et al., 2020, The Influence of Seasonal Factors on the Incidence of Peritoneal Dialysis-Associated Peritonitis. Ren Fail, 42(1): 807–817. https://doi.org/10.1080/0886022X.2020.1804401
Koks G, Uudelepp ML, Limbach M, et al., 2015, Smoking-Induced Expression of the GPR15 Gene Indicates Its Potential Role in Chronic Inflammatory Pathologies. Am J Pathol, 185(11): 2898–2906. https://doi.org/10.1016/j.ajpath.2015.07.006
Terada K, Sumi Y, Aratani S, et al., 2021, Smoking is a Risk Factor for Endogenous Peritonitis in Patients Undergoing Peritoneal Dialysis. J Nippon Med Sch, 88(5): 461–466. https://doi.org/10.1272/jnms.JNMS.2021_88-604
Boudville N, McCullough K, Bieber B, et al., 2023, A Different PET Test: The Relationship between Pet Ownership and Peritonitis Risk in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS). Perit Dial Int, 43(3): 263–267. https://doi.org/10.1177/08968608221144450
Cankaya E, Altunok M, Yaganoglu AM, 2023, The Effect of Rural and Urban Life on Peritonitis Rates in Chronic Peritoneal Patients. Ren Fail, 45(1): 2163504. https://doi.org/10.1080/0886022X.2022.2163504
Yin S, Tang M, Rao Z, et al., 2022, Risk Factors and Pathogen Spectrum in Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis: A Single Center Retrospective Study. Med Sci Monit, 28: e937112. https://doi.org/10.12659/MSM.937112
Wang X, Han Q, Wang T, et al., 2020, Serum Albumin Changes and Mortality Risk of Peritoneal Dialysis Patients. Int Urol Nephrol, 52: 565–571. https://doi.org/10.1007/s11255-020-02389-y
Biebuyck GKM, Jakulj L, Neradova A, et al., 2023, Low Immunoglobulin G Concentrations are not Associated with an Increased Risk of Peritoneal Dialysis-Related Peritonitis. Clin Nephrol, 99(4): 180–186. https://doi.org/10.5414/CN110966
Courivaud C, Bardonnet K, Crepin T, et al., 2015, Serum Immunoglobulin G Levels and Peritonitis in Peritoneal Dialysis Patients. J Nephrol, 28(4): 511–515. https://doi.org/10.1007/s40620-015-0176-2
van Esch S, van Diepen AT, Struijk DG, et al., 2016, The Mutual Relationship Between Peritonitis and Peritoneal Transport. Perit Dial Int, 36(1): 33–42. https://doi.org/10.3747/pdi.2014.00115
Zhao Z, Yan Q, Li D, et al., 2023, Relationship between Serum iPTH and Peritonitis Episodes in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis. Front Endocrinol (Lausanne), 14: 1081543. https://doi.org/10.3389/fendo.2023.1081543. Erratum in Front Endocrinol (Lausanne), 14: 1208563. https://doi.org/10.3389/fendo.2023.1208563
Liao CT, Zheng CM, Lin YC, et al., 2021, Aberrant Serum Parathyroid Hormone, Calcium, and Phosphorus as Risk Factors for Peritonitis in Peritoneal Dialysis Patients. Sci Rep, 11(1): 1171. https://doi.org/10.1038/s41598-020-80938-2. Erratum in Sci Rep, 12(1): 6515. https://doi.org/10.1038/s41598-022-10918-1
Diao X, Zheng Z, Yi C, et al., 2022, Association of Abnormal Iron Status with the Occurrence and Prognosis of Peritoneal Dialysis-Related Peritonitis: A Longitudinal Data-Based 10-Year Retrospective Study. Nutrients, 14(8): 1613. https://doi.org/10.3390/nu14081613
Huo Z, Zhuo Q, Zhong S, et al., 2022, Hypokalemia Duration in the First Year Associated with Subsequent Peritoneal Dialysis-Associated Peritonitis: A Multicenter Retrospective Cohort Study. J Clin Med, 11(24): 7518. https://doi.org/10.3390/jcm11247518
Liu D, Lin Y, Gong N, et al., 2021, Degree and Duration of Hypokalemia Associated with Peritonitis in Patients Undergoing Peritoneal Dialysis. Int J Clin Pract, 75(8): e14188. https://doi.org/10.1111/ijcp.14188
Pi HC, Ren YP, Wang Q, et al., 2015, Serum 25-Hydroxyvitamin D Level Could Predict the Risk for Peritoneal Dialysis-Associated Peritonitis. Perit Dial Int, 35(7): 729–735. https://doi.org/10.3747/pdi.2014.00177
Hu J, Zhang H, Yi B, 2021, Peritoneal Transport Status and First Episode of Peritonitis: A Large Cohort Study. Ren Fail, 43(1): 1094–1103. https://doi.org/10.1080/0886022X.2021.1949350
Hasegawa T, Noma H, Hamano T, et al., 2022, Association between the Use of Exchange Devices for Peritoneal Dialysis Fluids and Peritonitis Incidence: A Nationwide Cohort Study. Perit Dial Int, 42(2): 177–184. https://doi.org/10.1177/08968608211051591
Oka H, Yamada S, Kamimura T, et al., 2019, Better Oral Hygiene Habits Are Associated With a Lower Incidence of Peritoneal Dialysis-Related Peritonitis. Ther Apher Dial, 23(2): 187–194. https://doi.org/10.1111/1744-9987.12757
Cheetham MS, Zhao J, McCullough K, et al., 2022, International Peritoneal Dialysis Training Practices and the Risk of Peritonitis. Nephrol Dial Transplant, 37(5): 937–949. https://doi.org/10.1093/ndt/gfab298