Hi, just wondering if pre-PD peritonitis rate should be calculated together with regular peritonitis rate when calculating for the yearly peritonitis rate KPI? Or do they need to be calculated separately? Thank you

Questions About PD

Mary Grace Pasadilla, Nurse from Australia asked
Hi, just wondering if pre-PD peritonitis rate should be calculated together with regular peritonitis rate when calculating for the yearly peritonitis rate KPI? Or do they need to be calculated separately? Thank you

1 answer

Nurse Canada with members of the ISPD Nursing Committee June 29, 2024

We thank you for your most interesting question concerning how best to calculate the yearly peritonitis rate: with pre-PD peritonitis rate included with peritonitis rate after PD start OR calculated separately. We have conducted a small survey among members of our ISPD Nursing Group (Australia, Brazil, Canada, New Zealand, Portugal, UK, USA) about the practices in the home PD units they are most familiar with. The responses were quite varied:
 
– in some units the peritonitis rates are calculated from the time of insertion of the PD catheter, then continuing through PD start and onwards (one set of data)
 
– some units collect data together (from time of PD catheter insertion to PD start, from PD start onwards), but they can be separated out
 
– some units collect data separately, from time of PD catheter insertion to PD start, as one set of data; from PD start onwards (counted from first use of PD catheter – in training, IPD or acute PD) as a second set of data
 
– another variation is: from time of PD catheter insertion until one month after PD start; however, focus is on established patients — one month after PD start onwards
 
– yet another variation is: post PD catheter insertion captured on paper (unable to track with electronic record); from first day of home PD training onwards captured on electronic record
 
– one PD unit collects data after PD start and onwards (counted from first day of PD at home); but is considering additionally to start collecting separately from the time of insertion of the PD catheter to PD start.
 
Until there are further updates from the authors of the ISPD Peritonitis Guideline Recommendations on the practice of how best to collect data on peritonitis rates, we would suggest PD units collect data from time of PD catheter insertion to PD start, then from PD start onwards. Whether these data should be combined or kept separately, is not clear from the latest ISPD Guidelines (1,2).
 
1.Li PK, Chow KM, Cho Y, Fan S, Figueiredo AE, Harris T, Kanjanabuch T, Kim YL, Madero M, Malyszko J, Mehrotra R. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Peritoneal dialysis international. 2022 Mar;42(2):110-53. Available at: https://journals.sagepub.com/doi/pdf/10.1177/08968608221080586
 
 
2.Crabtree JH, Shrestha BM, Chow KM, Figueiredo AE, Povlsen JV, Wilkie M, Abdel-Aal A, Cullis B, Goh BL, Briggs VR, Brown EA. Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Peritoneal Dialysis International. 2019 Sep;39(5):414-36. https://journals.sagepub.com/doi/pdf/10.3747/pdi.2018.00232
 

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