Peritonitis is a frequent complication of
peritoneal dialysis (PD) in children as well in adults. Data on PD and
peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and
peritonitis epidemiology in pediatric patients in South Africa and identify risk factors for
peritonitis. Baseline characteristics and potential risk factors of
peritonitis were recorded, including housing, socio-economic circumstances, distance to PD center, type of PD, mode of
catheter placement, race, presence of
gastrostomy tube, weight, and height. Outcome indices for
peritonitis were
peritonitis rate, time to first
peritonitis, and number of
peritonitis-free patients. The patient cohort comprised 67 patients who were on PD for a total of 544 months. The total number of
peritonitis episodes was 129. Median
peritonitis rate was one episode every 4.3 patient months (2.8 episodes/patient-year, range 0-21.2). Median time to first
infection was 2.03 months (range 0.1-21.5 months), and 28.4% of patients remained free from
peritonitis. Patients with good housing and good socio-economic circumstances had a significantly lower
peritonitis rate and a longer time to first
peritonitis episode.
Peritonitis rate was high in this cohort, compared to numbers reported for the developed world; the characteristics of causative organisms are comparable. The most important risk factors for the development of
peritonitis were poor housing and poor socio-economic circumstances. More intensive counseling may be beneficial, but improvement of general socio-economic circumstances will have the greatest influence on PD success.