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Peritonitis is still an important factor for withdrawal from peritoneal dialysis therapy in the Tokai area of Japan

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Clinical and Experimental Nephrology Aims and scope Submit manuscript

Abstract

Background

In Japan, the population of patients on peritoneal dialysis (PD) is <4% of the total number of patients with end-stage renal disease. Few systemic analyses have examined why the number of PD patients has not increased in Japan. We organized a registry to analyze PD patients and retrospectively investigated 561 PD patients (about 5% of all Japanese PD patients) from 13 hospitals in the Tokai area for 3 years from 2005.

Methods

We investigated background, physical status, laboratory data, status of PD therapy, and the occurrence of PD-related complications, and analyzed reasons for withdrawal from PD.

Results

Nutrition did not change significantly during our observation. Urinary volume showed continued decreases after the introduction period. In contrast, PD fluid demand and ultrafiltration volume were significantly increased. For calcium metabolism, multiple phosphate binders were required after the second year of PD therapy. Early drop-out within 3 years after starting PD therapy comprised 50.9% of total withdrawals, with PD-related peritonitis as the most common reason, mainly caused by Gram-positive organisms. Incidence of peritonitis was 42.8 months/patient. Culture-negative results were obtained for 32% of peritonitis cultures. Diabetes affects the prognosis of PD therapy, but not the incidence of peritonitis.

Conclusion

We examined clinical status over 3 years in the Tokai area. The results suggest that the incidence of peritonitis needs to be decreased to prevent early withdrawal of PD patients. Education systems to decrease the incidence of peritonitis and techniques to decrease culture-negative results might be important for improving the prognosis of peritonitis.

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Acknowledgments

The authors wish to offer special thanks to Ms. Onishi and Ms. Kato for their assistance in creating the database, and to Mr. Nakamura for help with statistical analyses. We are also grateful to the medical and co-medical staff who helped with registration of PD patients and data collection for our registration system.

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Authors and Affiliations

  1. Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Tsurumai-cho 65, Showa-ku, Nagoya, Japan

    Masashi Mizuno, Yasuhiko Ito, Yasuhiro Suzuki & Hideki Hiramatsu

  2. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Masashi Mizuno, Yasuhiko Ito, Yasuhiro Suzuki, Isao Ito, Shoichi Maruyama, Enyu Imai, Yukio Yuzawa & Seiichi Matsuo

  3. Chubu Rosai Hospital, Nagoya, Japan

    Akio Tanaka & Hideaki Shimizu

  4. Handa City Hospital, Handa, Japan

    Midoriko Watanabe

  5. Minami Seikyo Hospital, Nagoya, Japan

    Yoshikazu Tsuruta

  6. Ogaki Kita Clinic, Ogaki, Japan

    Teppei Matsuoka

  7. Yokkaichi Municipal Hospital, Yokkaichi, Japan

    Isao Ito

  8. Anjo Kosei Hospital, Anjo, Japan

    Hiroshi Tamai

  9. Nagoya Kyoritsu Hospital, Nagoya, Japan

    Hirotake Kasuga

  10. Toyota Kosei Hospital, Toyota, Japan

    Hisashi Kurata

  11. Tosei General Hospital, Seto, Japan

    Daijo Inaguma

  12. Konan Kosei Hospital, Konan, Japan

    Takeyuki Hiramatsu

  13. Daiyukai Daiichi Hospital, Ichinomiya, Japan

    Masanobu Horie

  14. Kasugai Municipal Hospital, Kasugai, Japan

    Tomohiko Naruse

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  1. Masashi Mizuno
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  2. Yasuhiko Ito
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  21. Seiichi Matsuo
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Corresponding author

Correspondence to Masashi Mizuno.

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Mizuno, M., Ito, Y., Tanaka, A. et al. Peritonitis is still an important factor for withdrawal from peritoneal dialysis therapy in the Tokai area of Japan. Clin Exp Nephrol 15, 727–737 (2011). https://doi.org/10.1007/s10157-011-0471-8

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  • DOI: https://doi.org/10.1007/s10157-011-0471-8

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